Ketoacidosis at diabetes onset is still frequent in children and adolescents: a multicentre analysis of 14,664 patients from 106 institutions
- Andreas Neu, MD (andreas.neu{at}med.uni-tuebingen.de)1,
- Sabine E. Hofer, MD2,
- Beate Karges, MD3,
- Rudolf Oeverink, MD4,
- Joachim Rosenbauer, MD5,
- Reinhard W. Holl, MD6 and
- for the DPV initiative and the German BMBF Competency Network for Diabetes Mellitus
- 1 University Children's Hospital, Tübingen, Germany
- 2 Dept. of Pediatrics, Medical University of Innsbruck, Austria
- 3 RWTH Aachen University, Dept. of Endocrinology and Pediatrics, Germany
- 4 Endocrine Consulting Practitioner, Oldenburg, Germany
- 5 Deutsches Diabetes Zentrum, Düsseldorf University, Germany
- 6 University of Ulm, Dept. of Epidemiology, Ulm, Germany
Abstract
Objective: We aimed at analyzing the frequency, clinical characteristics, and trends associated with the occurrence of ketoacidosis at the onset of type 1 diabetes mellitus on the basis of long-term follow-up data.
Research design and methods: A total of 106 paediatric diabetes centres in Germany and Austria participated in this study. Data of 14,664 patients with type 1 diabetes collected between 1995 and 2007 were suitable for evaluation. Ketoacidosis (DKA) was defined and classified according to the ISPAD consensus guidelines.
Results: DKA was observed in 21.1% of patients. The frequency of DKA, including the severe form, remained unchanged throughout the 13 years' observation period. The frequency of DKA was particularly striking among children < 5 years of age (26.5%).
Conclusions: Ketoacidosis occurring at diabetes onset continues to be a difficult problem. Our data show no significant change in the frequency and magnitude of DKA over the last 13 years.
Footnotes
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- Received March 20, 2009.
- Accepted June 16, 2009.
- Copyright © American Diabetes Association
