University of Jordan School of Medicine, Department of Pediatrics, Amman, Jordan
AI-Ahliyya Amman University, Faculty of Pharmacy, Pharmacological and Diagnostic Research Center, Amman, Jordan
J Clin Res Pediatr Endocrinol. 2023 Feb 27;15(1):46-54. doi: 10.4274/jcrpe.galenos.2022.2022-5-8. Epub 2022 Oct 20.
Data regarding diabetic ketoacidosis (DKA) at diagnosis of type one diabetes (T1D) in developing countries are scarce. The aim of this study was to describe the frequency of DKA at the onset of T1D in children and adolescents in Jordan and to compare the clinical and biochemical characteristics between the group that presented with DKA and the group that did not.
The records of 341 children and adolescents, less than sixteen years of age, who were diagnosed with T1D between 2015 and 2019 were evaluated retrospectively.
Of all the children diagnosed with T1D, 108 (31.7%) presented with DKA. The majority had mild or moderate DKA (38% and 33.3% respectively). Higher paternal education levels were associated with a lower probability of presenting with DKA (p=0.043). A family history of T1D had a protective effect on the occurrence of DKA (Odds ratio=2.138; 95% confidence interval=1.167-3.917, p=0.014). Patients with celiac disease and higher HbA1c levels were more likely to experience recurrent episodes of DKA, (p=0.004 and 0.011, respectively).
In Jordan, the rate of DKA at presentation of T1D remains high. Prevention campaigns are needed to increase diabetes awareness among the public and healthcare providers.
有关发展中国家 1 型糖尿病（T1D）诊断时糖尿病酮症酸中毒（DKA）的数据很少。本研究旨在描述约旦儿童和青少年 T1D 发病时 DKA 的频率，并比较出现 DKA 与未出现 DKA 两组的临床和生化特征。
回顾性评估了 2015 年至 2019 年间诊断为 T1D 的 341 名年龄小于 16 岁的儿童和青少年的记录。
在所有诊断为 T1D 的儿童中，有 108 例（31.7%）出现 DKA。大多数为轻度或中度 DKA（分别为 38%和 33.3%）。父亲受教育程度较高与出现 DKA 的概率较低相关（p=0.043）。T1D 的家族史对 DKA 的发生具有保护作用（优势比=2.138；95%置信区间=1.167-3.917，p=0.014）。患有乳糜泻和 HbA1c 水平较高的患者更有可能出现反复 DKA 发作（分别为 p=0.004 和 0.011）。
在约旦，T1D 发病时 DKA 的发生率仍然很高。需要开展预防运动，提高公众和医疗保健提供者对糖尿病的认识。
