Affiliation:
1. Paediatric Endocrinology and Diabetes Department , 612518 Tripoli Children’s Hospital , Tripoli , Libya
2. Paediatric Department, Faculty of Medicine , University of Tripoli , Tripoli , Libya
Abstract
Abstract
Objectives
Diabetic ketoacidosis (DKA) stands as a critical, acute complication of type 1 diabetes. Despite its severity, there exists a dearth of data concerning the frequency and prevalence of DKA at the onset of type 1 diabetes in Libyan children. This study aimed to ascertain the frequency of DKA during the initial presentation of type 1 diabetes among children aged 0.5–14 years admitted to Tripoli Children’s Hospital between 2011 and 2018.
Methods
Employing a retrospective approach, the study examined the proportion of children with newly diagnosed type 1 diabetes who presented with DKA. Data analysis included estimating DKA frequency concerning age at presentation, sex, and age groups. The comparative analysis involved assessing DKA frequency between 0.5 and <2 and 2–14 years age groups. Logistic regression analysis evaluated the impact of age group, sex, and family history of type 1 diabetes on DKA and severe DKA occurrence.
Results
Among 497 children with newly diagnosed type 1 diabetes, 39.2 % presented with DKA, of these 44.5 % had severe DKA. Females exhibited a higher DKA rate than males (OR 1.63, 95 % CI 1.13–2.34, p=0.009). Very young children (0.5 to <2 years) presented with DKA more frequently than those aged 2–14 years (OR 4.73, 95 % CI 2.65–8.47, p<0.001), and they were more likely to present in severe DKA (63.9 vs. 39.1 %, [OR 7.26, 95 % CI 3.65–14.41, p<0.001]).
Conclusions
The frequency of DKA at type 1 diabetes onset among children admitted to Tripoli Children’s Hospital is notably high, with nearly half of the DKA episodes categorized as severe. Very young children notably demonstrated a fivefold increase in the likelihood of presenting with DKA.
Reference40 articles.
1. Libman, I, Haynes, A, Lyons, S, Pradeep, P, Rwagasor, E, Tung, JYL, et al.. ISPAD clinical practice consensus guidelines 2022: definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes 2022;23:1160–74. https://doi.org/10.1111/pedi.13454.
2. Tuomilehto, J, Ogle, GD, Lund-Blix, NA, Stene, LC. Update on worldwide trends in occurrence of childhood type 1 diabetes in 2020. Pediatr Endocrinol Rev 2020;17:198–209. https://doi.org/10.17458/per.vol17.2020.tol.epidemiologychildtype1diabetes.
3. International Diabetes Federation. IDF diabetes Atlas, 10th ed.; 2021. https://diabetesatlas.org/idfawp/resource-files/2021/07/IDF_Atlas_10th_Edition_2021.pdf [Accessed 6 Dec 2021].
4. Khashebi, RM, Patterson, CC, Shebani, MS. The incidence trend of type 1 diabetes among children and adolescents 0-14 years of age in the West, South, and Tripoli regions of Libya (2009–2018). J Clin Res Pediatr Endocrinol 2023;15:356–64. https://doi.org/10.4274/jcrpe.galenos.2023.2023-1-17.
5. Wersäll, JH, Adolfsson, P, Forsander, G, Ricksten, S-E, Hanas, R. Delayed referral is common even when new-onset diabetes is suspected in children. A Swedish prospective observational study of diabetic ketoacidosis at onset of type 1 diabetes. Pediatr Diabetes 2021;22:900–8. https://doi.org/10.1111/pedi.13229.