EVALUATION OF RISK FACTORS FOR RECURRENT DIABETIC KETOACIDOSIS IN CHILDREN WITH TYPE 1 DIABETES

The most frequent hyperglycemic emergency is diabetic ketoacidosis (DKA), which puts individuals with diabetes mellitus at the highest risk of mortality that may be avoided. DKA affects people with type 1 diabetes more frequently than type 2, with 30% of occurrences in patients who have already been diagnosed with type 2 diabetes. High blood sugar level, ketosis and metabolic acidosis are symptoms of DKA. The aim of the study is to emphasize the main manifestation of type 1 diabetes which is diabetic ketoacidosis, as well as, to analyze the factors predisposing to recurrent episodes of diabetic ketoacidosis. Material and Methods. The retrospective study was conducted on a period between 2017-2022, including hospitalized children aged between 0-16 years with recurrent diabetic ketoacidosis within the Pediatric Clinic of Clinical Emergency Hospital "St. Andrew the Apostle" Constanta, aiming to analyze the factors predisposing to recurrent episodes of diabetic ketoacidosis according to age, sex, environment, socio-economic status, heredo-collateral antecedents, symptoms, personal pathological history, clinical and laboratory data. Results. It was observed that the incidence of episodes of diabetic ketoacidosis increased considerably since 2019, the maximum being recorded in 2020, while the lowest percentage is in 2017. During 2020-2021, the age group of 10-14 years presented. Genetic sex remains a nonmodifiable risk factor that is thought to play a role in terms of glycemic control, but also the occurrence of complications in patients with type 1 diabetes. It was shown that 37% of the causes of the recurrence of DKA episodes were found to be diet variation, 28% to be viral diseases, 26% to be insulin administration errors, 6% to be trauma, and only 3% to be Mauriac syndrome. Conclusions. Numerous research from the medical literature have supported the hypothesis that SARSCoV-2 may be a catalyst for autoimmunity in the pathogenesis of type 1 diabetes, indicating a causal connection between the two illnesses. It has been established that diet non-compliance is the primary cause of recurrent episodes of ketoacidosis.