Pediatric Endocrine Unit, Mubarak Alkabeer Hospital, Kuwait City, State of Kuwait.
Pediatr Diabetes. 2010 Aug;11(5):351-6. doi: 10.1111/j.1399-5448.2009.00600.x.
Diabetic ketoacidosis (DKA) has significant morbidity and mortality, and is common at diagnosis in children.
Describe the frequency and severity of DKA at diagnosis of type 1 diabetes mellitus (T1DM) in children in Kuwait.
Hospital records of 677 diabetic children less than 12 yr of age, diagnosed during the period of 2000-2006 were reviewed. DKA was defined as blood glucose > 11 mmol/L, pH < 7.3, and/or bicarbonate < 15 mmol/L with ketonuria.
Of all patients diagnosed with T1DM, 255 (37.7%) presented with DKA. The frequency of DKA was constant between 2000 and 2002 (42.7-41.5%), but decreased in the following years to 30.7% in 2006 (p < 0.005). The majority had either mild or moderate DKA (74.1%). Fifty-one (36.7%) of all children in the 0-4 yr had severe DKA compared to ten (2.9%) in the 5- to 8-yr-old group, and three (1.5%) in 9- to 12-yr-old patients (p < 0.0001). Moreover, 83% of children with severe DKA were in the 0-4 yr age group. One child (0.15%) died and twenty-seven (4%) needed intensive care unit (ICU) care.
Our study provides recent data on Middle Eastern population, for whom data are sparse. Although it has significantly decreased, the frequency of DKA at presentation of T1DM in children in Kuwait is still high, secondary to the high prevalence of diabetes in the community. Young children, especially those less than 2 yr old remain at high risk. Increasing the general awareness of the public as well as of pediatricians to the disease may lead to early diagnosis before the development of acidosis.
糖尿病酮症酸中毒（DKA）具有显著的发病率和死亡率，并且在儿童中常见于诊断时。
描述科威特儿童 1 型糖尿病（T1DM）诊断时 DKA 的频率和严重程度。
回顾了 2000 年至 2006 年期间诊断的 677 名年龄小于 12 岁的糖尿病儿童的住院记录。DKA 定义为血糖> 11 mmol/L、pH < 7.3 和/或碳酸氢盐< 15 mmol/L 伴酮尿。
在所有诊断为 T1DM 的患者中，有 255 例（37.7%）出现 DKA。2000 年至 2002 年期间，DKA 的发生率保持不变（42.7-41.5%），但在随后的几年中降至 2006 年的 30.7%（p < 0.005）。大多数患者患有轻度或中度 DKA（74.1%）。所有 0-4 岁儿童中有 51 例（36.7%）患有重度 DKA，而 5-8 岁组有 10 例（2.9%），9-12 岁组有 3 例（1.5%）（p < 0.0001）。此外，83%患有重度 DKA 的儿童年龄在 0-4 岁之间。有 1 例儿童（0.15%）死亡，有 27 例（4%）需要重症监护病房（ICU）护理。
本研究提供了中东人群的最新数据，而该地区的数据相对较少。尽管它已经显著下降，但科威特儿童 T1DM 就诊时 DKA 的频率仍然很高，这是由于社区中糖尿病的高患病率所致。幼儿，尤其是 2 岁以下的幼儿，仍然面临高风险。提高公众和儿科医生对这种疾病的普遍认识可能会导致在酸中毒发生之前进行早期诊断。
