Department of Endocrinology, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, 33 Longhu Outer Ring East Road, Zhengzhou, Henan, 450018, People's Republic of China.
Vanke School of Public Health, Tsinghua University, Beijing, China.
BMC Pediatr. 2023 Jan 23;23(1):39. doi: 10.1186/s12887-023-03847-z.
Type 1 diabetes mellitus (T1DM) is a common chronic systemic disease that threatens the health of children worldwide. Diabetic ketoacidosis (DKA) is the most severe acute complication of diabetes and can lead to death. This study aimed to explore the epidemiological features, clinical manifestations, and risk factors for DKA in children and adolescents newly diagnosed with T1DM in the Department of Endocrinology of the Children's Hospital of Henan Province.
Medical records of 683 children and adolescents newly diagnosed with T1DM in our center from March 2014 to November 2021 were retrospectively analyzed. The data included the general condition, laboratory indexes, and clinical symptoms. The patients were divided into three groups according to age: Group I, 0-3 years; Group II, 4-9 years; and Group III, 10-18 years.
The incidence of DKA was 62.96% and was highest in Group I. Group I had the lowest C-peptide and hemoglobin A1c, but the highest blood glucose at first diagnosis, and 25-hydroxyvitamin D3 levels, hospitalization lengths, and medical costs. 25.5% of the children were delayed in diagnosis. Logistic regression analysis showed that elevated HbA1c levels and hyperglycemia were independent risk factors for DKA. On the other hand, C-peptide and 25- hydroxyvitamin D were protective factors for DKA.
The incidence of DKA among children and adolescents in the Henan Province is very high. Moreover, DKA can be easily delayed in diagnosis. Newly diagnosed infants with T1DM are more likely to present with DKA, suffer more severe metabolic disorders, endure longer hospital stays, and accrue higher medical costs.
1 型糖尿病（T1DM）是一种常见的慢性全身性疾病，威胁着全球儿童的健康。糖尿病酮症酸中毒（DKA）是糖尿病最严重的急性并发症，可导致死亡。本研究旨在探讨河南省儿童医院内分泌科新诊断的 T1DM 患儿的流行病学特征、临床表现和 DKA 的危险因素。
回顾性分析 2014 年 3 月至 2021 年 11 月我院收治的 683 例新诊断的 T1DM 患儿的病历资料。资料包括一般情况、实验室指标和临床症状。根据年龄将患儿分为三组：I 组，0-3 岁；II 组，4-9 岁；III 组，10-18 岁。
DKA 的发生率为 62.96%，I 组最高。I 组 C 肽和血红蛋白 A1c 最低，但初诊时血糖最高，25-羟维生素 D3 水平最低，住院时间、住院费用也最高。有 25.5%的患儿延误诊断。Logistic 回归分析显示，HbA1c 水平升高和高血糖是 DKA 的独立危险因素。另一方面，C 肽和 25-羟维生素 D 是 DKA 的保护因素。
河南省儿童和青少年 DKA 的发生率非常高。此外，DKA 容易被延误诊断。新诊断的婴儿 T1DM 更易发生 DKA，代谢紊乱更严重，住院时间更长，医疗费用更高。
