Shaltout Azza Aly, Channanath Arshad Mohamed, Thanaraj Thangavel Alphonse, Omar Dina, Abdulrasoul Majedah, Zanaty Nabila, Almahdi Maria, Alkandari Hessa, AlAbdulrazzaq Dalia, d'Mello Linda, Mandani Fawziya, Alanezi Ayed, AlBasiry Eman, Alkhawari M
Dasman Diabetes Institute, Pediatric Research Unit, Capital 15462 Kuwait.
Dasman Diabetes Institute, Department of Integrative Informatics, Capital 15462 Kuwait.
Sci Rep. 2016 Jun 22;6:27519. doi: 10.1038/srep27519.
We examined the frequency and severity of diabetic ketoacidosis (DKA) in 679 children and adolescents (0-14 years) at diagnosis of Type 1 Diabetes Mellitus (T1DM) in Kuwait. Between 1(st) January 2011 and 31(st) December 2013, all newly diagnosed children with diabetes were registered prospectively in a population-based electronic register. DKA was diagnosed using standard criteria based on the levels of venous pH and serum bicarbonate. At the time of diagnosis, mild/moderate DKA was present in 24.8% of the children, while severe DKA was present in 8.8%. Incidence of ketoacidosis was significantly higher in young children less than 2 (60.7% vs 32.4% p = <0.005) compared to children 2-14 years old, and a higher proportion presented with severe DKA (21.4% vs 8.3% p = <0.05). No association was seen with gender. Significant differences were found in the incidence of DKA between Kuwaiti and non-Kuwaiti children (31.1% vs 39.8%; p < 0.05). Family history of diabetes had a protective effect on the occurrence of DKA (OR = 0.44; 95% CI = 0.27-0.71). Incidence of DKA in children at presentation of T1DM remains high at 33.6%. Prevention campaigns are needed to increase public awareness among health care providers, parents and school teachers in Kuwait.
我们调查了科威特679名0至14岁1型糖尿病（T1DM）确诊儿童及青少年糖尿病酮症酸中毒（DKA）的发生频率及严重程度。在2011年1月1日至2013年12月31日期间，所有新诊断的糖尿病儿童均前瞻性地登记到一个基于人群的电子登记系统中。DKA根据静脉血pH值和血清碳酸氢盐水平的标准进行诊断。诊断时，24.8%的儿童存在轻度/中度DKA，而重度DKA的比例为8.8%。与2至14岁儿童相比，2岁以下幼儿的酮症酸中毒发生率显著更高（60.7%对32.4%，p = <0.005），且重度DKA的比例更高（21.4%对8.3%，p = <0.05）。未发现与性别有关联。科威特儿童与非科威特儿童的DKA发生率存在显著差异（31.1%对39.8%；p < 0.05）。糖尿病家族史对DKA的发生有保护作用（OR = 0.44；95% CI = 0.27 - 0.71）。T1DM确诊儿童中DKA的发生率仍高达33.6%。科威特需要开展预防活动，以提高医疗保健人员、家长和学校教师的公众意识。
