Diabetic ketoacidosis in children with new-onset type 1 diabetes mellitus: demographics, risk factors and outcome: an 11 year review in Hong Kong

被引:2
作者
Poon, Sarah Wing-Yiu [2 ]
Tung, Joanna Yuet-Ling [1 ]
Wong, Wilfred Hing-Sang [2 ]
Cheung, Pik-To [2 ]
Fu, Antony Chun-Cheung [3 ]
Pang, Gloria Shir-Wey [3 ,4 ]
To, Sharon Wing-Yan [3 ]
Wong, Lap-Ming [5 ]
Wong, Wai-Yu [5 ]
Chan, Suk-Yan [6 ]
Yau, Ho-Chung [6 ]
See, Wing-Shan [2 ]
But, Betty Wai-Man [7 ]
Wong, Shirley Man-Yee [7 ]
Lo, Priscilla Wai-Chee [8 ]
Ng, Kwok-Leung [8 ]
Chan, Kwong-Tat [9 ]
Lam, Hi-Yuet [10 ]
Wong, Sammy Wai-Chun [10 ]
Lam, Yuen-Yu [11 ]
Yuen, Hoi-Wing [11 ]
Chung, Jacky Ying-Ki [12 ]
Lee, Ching-Yee [12 ]
Tay, Ming-Kut [13 ]
Kwan, Elaine Yin-Wah [9 ]
机构
[1] Hong Kong Childrens Hosp, Dept Paediat, Kowloon, 1 Shing Cheong Rd, Hong Kong, Peoples R China
[2] Univ Hong Kong, Queen Mary Hosp, LKS Fac Med, Dept Paediat & Adolescent Med, Hong Kong, Peoples R China
[3] Princess Margaret Hosp, Dept Paediat & Adolescent Med, Hong Kong, Peoples R China
[4] Hong Kong Childrens Hosp, Dept Paediat & Adolescent Med, Hong Kong, Peoples R China
[5] Tuen Mun Hosp, Dept Paediat & Adolescent Med, Hong Kong, Peoples R China
[6] Prince Wales Hosp, Dept Paediat, Hong Kong, Peoples R China
[7] Queen Elizabeth Hosp, Dept Paediat, Hong Kong, Peoples R China
[8] United Christian Hosp, Dept Paediat & Adolescent Med, Hong Kong, Peoples R China
[9] Pamela Youde Nethersole Eastern Hosp, Dept Paediat & Adolescent Med, Hong Kong, Peoples R China
[10] Alice Ho Miu Ling Nethersole Hosp, Dept Paediat & Adolescent Med, Hong Kong, Peoples R China
[11] Kwong Wah Hosp, Dept Paediat, Hong Kong, Peoples R China
[12] Caritas Med Ctr, Dept Paediat & Adolescent Med, Hong Kong, Peoples R China
[13] Tseung Kwan O Hosp, Dept Paediat & Adolescent Med, Hong Kong, Peoples R China
关键词
diabetic ketoacidosis; Hong Kong; pediatrics; risk factors; type 1 diabetes mellitus; CEREBRAL EDEMA; YOUNG-CHILDREN; DIAGNOSIS; EPIDEMIOLOGY; ADOLESCENTS; AUTOIMMUNE; PREVALENCE; FREQUENCY; GLUCOSE; SEARCH;
D O I
10.1515/jpem-2022-0255
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes (T1D). The aim of this study is to analyze the incidence, clinical characteristics, management and outcome of children presenting with DKA in new-onset T1D from 2008 to 2018 in Hong Kong. Methods Data was extracted from the Hong Kong Childhood Diabetes Registry. All subjects less than 18 years with newly diagnosed T1D from 1 January 2008 to 31 December 2018 managed in the public hospitals were included. Information on demographics, laboratory parameters, DKA-related complications and management were analyzed. Results In the study period, there were 556 children with newly diagnosed T1D in our registry and 43.3% presented with DKA. The crude incidence rate of new-onset T1D with DKA was 1.79 per 100,000 persons/year (CI: 1.56-2.04). Subjects presenting with DKA were younger (9.5 +/- 4.5 vs. 10.5 +/- 4.4, p=0.01) and had shorter duration of symptoms (4.2 +/- 5.9 days vs. 10.6 +/- 17.1 days, p<0.01). Regarding management, up to 12.4% were given insulin boluses and 82.6% were started on insulin infusion 1 h after fluid resuscitation. The rate of cerebral edema was 0.8% and there was no mortality. Conclusions Younger age and shorter duration of symptoms were associated with DKA in new-onset T1D. Despite availability of international guidelines, there was inconsistency in acute DKA management. These call for a need to raise public awareness on childhood diabetes as well as standardization of practice in management of pediatric DKA in Hong Kong.
引用
收藏
页码:1132 / 1140
页数:9
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