Abstract
Objective To summarize the clinical features of diabetic ketoacidosis (DKA) in children with newly diagnosed type 1 diabetes mellitus(T1DM), and to explore the predictors of DKA by analyzing these factors in order to achieve early recognition. Methods In this retrospective study, 200 children with newly-onset T1DM from January 2009 to December 2012 in Shengjing Hospital of China Medical University were chosen.These patients were divided into DKA group and non-DKA group.Clinical data including age, gender, health insurance, body shape, infection history, family history of diabetes, type of residence, income, duration of history, C peptide, glycosylated hemoglobin, blood lipids, thyroid tests, diabetes antibodies etc were collected. Results Among 200 cases of newly diagnosed T1DM, 107 children had DKA, 93 children had non-DKA, and the incidence of DKA was 53.5%.In the group of DKA, 39 cases (36.5%) were male, 68 cases were female, while in the group of non-DKA 45 cases (48.4%) were male, 48 cases were female.In the group of DKA, children ranged in age from 16 months to 13 years old, and the average age was (6.53±3.55) years old.In the non-DKA group, children ranged in age from 1 to 14 years old, and the average age was (7.05±3.55)years old.In the group of DKA, 43 cases (40.2%) didn't have health insurance, while in the non-DKA group, 28 cases (30.1%) didn't have medical insurance.In the DKA group, 30 cases (28%) had a family history of diabetes, while in the non-DKA group, 27 cases (29%) had a family history of diabetes.In the group of DKA, the duration was (30.24±76.50 )days, while in the group of non-DKA, the duration was (33.38±49.30) days.The glycosylated hemoglobin in the DKA group was (12.38±2.66)%, in the non-DKA group was (12.48±2.24)%.There were no significantly differences of the above factors between the 2 groups(all P>0.05). In the group of DKA, 35 cases(32.7%) were thin, 66 cases(61.7%) were of normal size, and 6 cases(5.6%) were fat.In the group of non-DKA, 9 cases(9.3%) were thin, 76 cases (78.6%) were of normal size, and 8 cases(12.1%) were fat.In the group of DKA, 33 cases(30.8%) had infection history, 77 cases(72%) lived in rural areas, and the average of C peptide was (0.25±0.22) μg/L.In the group of non-DKA, 17 cases(18.3%) had infection history, 52 cases(55.9%) in rural areas, and the average of C peptide was (0.36±0.21) μg/L.There were significant differences of the above factors between the 2 groups(all P<0.05). Conclusions Children with newly diagnosed T1DM who is thin, rural resident, and has lower C peptide level is more susceptible to DKA.More attention should be paid to the children with newly diagnosed T1DM who have above characteristics. Key words: Type 1 diabetes mellitus; Diabetic ketoacidosis; Affect factor; Child
Published Version
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