College of Health Sciences, Debre-Markos University, Debre-Markos, Ethiopia.
School of Nursing and Midwifery, College of Allied Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Ital J Pediatr. 2020 Nov 3;46(1):164. doi: 10.1186/s13052-020-00930-4.
Recurrent diabetic ketoacidosis in patients with known diabetes mellitus remains a relevant problem in pediatrics with an incidence of 1-10% per patient. Children may die because of cerebral edema and had a significant mortality (24%) and morbidity (35%).
We assessed the incidence and predictors of diabetic ketoacidosis among diabetes children at East and West Gojjam zone referral hospitals, North West Ethiopia, 2019.
An institution-based retrospective follow up study was conducted on children who were registered from January 1, 2014, to January 1, 2019. Epi data version 3.1 & Stata 14 were used for data entering and analysis respectively.
Out of 354 children included in the study, 207 (58.5%) developed diabetic ketoacidosis. The overall incidence rate of diabetic ketoacidosis was 2.27/100 children/month of observation. Age < 5 years (AHR: 3.52, 95% CI (2.25, 5.49), non-adherence (AHR: 1.54, 95% CI (1.11, 2.14), inappropriate insulin storage (AHR: 1.36, 95% CI (1.008, 1.85), presence of upper respiratory tract infections during diabetic ketoacidosis diagnose (AHR: 2.22, 95% CI (1.11, 4.45) and preceding gastroenteritis (AHR: 2.18, 95% CI (1.07, 4.44) were significant predictors.
Age < 5 years old, non-adherence, inappropriate insulin placement at home, preceding gastroenteritis, and presence of upper respiratory tract infections at the time of diabetic ketoacidosis development were significant predictors. Hence, assessing and close monitoring as well as strengthened diabetic education should be given for the above predictors.
已知患有糖尿病的患者反复发生糖尿病酮症酸中毒仍然是儿科的一个相关问题,发病率为每位患者 1-10%。儿童可能因脑水肿而死亡,死亡率(24%)和发病率(35%)均较高。
我们评估了 2019 年在埃塞俄比亚西北部东沃洛和西沃洛地区转诊医院的糖尿病儿童中糖尿病酮症酸中毒的发生率和预测因素。
这是一项基于机构的回顾性随访研究,研究对象为 2014 年 1 月 1 日至 2019 年 1 月 1 日期间登记的儿童。EpiData 版本 3.1 和 Stata 14 分别用于数据输入和分析。
在 354 名纳入研究的儿童中,有 207 名(58.5%)发生了糖尿病酮症酸中毒。糖尿病酮症酸中毒的总发生率为 2.27/100 名儿童/观察月。年龄<5 岁(AHR:3.52,95%CI(2.25,5.49))、不遵医嘱(AHR:1.54,95%CI(1.11,2.14))、胰岛素储存不当(AHR:1.36,95%CI(1.008,1.85))、糖尿病酮症酸中毒诊断时存在上呼吸道感染(AHR:2.22,95%CI(1.11,4.45))和先前发生胃肠炎(AHR:2.18,95%CI(1.07,4.44))是显著的预测因素。
年龄<5 岁、不遵医嘱、家中胰岛素放置不当、先前发生胃肠炎以及糖尿病酮症酸中毒发生时存在上呼吸道感染是显著的预测因素。因此,应评估和密切监测上述预测因素,并加强糖尿病教育。