From the Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
Saudi Med J. 2024 May;45(5):502-509. doi: 10.15537/smj.2024.45.4.20240058.
To evaluate clinical indicators in order to examine the intensity of diabetes ketoacidosis (DKA) episodes in children and adolescents diagnosed with type 1 diabetes mellitus (T1DM).
Data from 156 T1DM patients aged 6 months to 14 years, who presented with DKA to the emergency room, were retrospectively reviewed from 2018 to 2022. Data on demographic characteristics, economic status, initial clinical presentation, glycemic control, DKA severity, and laboratory evaluations were also collected.
Diabetes ketoacidosis episodes were more prevalent among male patients during the middle childhood age group. Notably, these episodes displayed seasonal patterns. The severity was found to be inversely associated with economic status and positively correlated with early adolescence. Newly diagnosed T1DM patients constituted 52.9%, with a statistically significant connection observed between severe DKA and this subgroup. Furthermore, there was a significant escalation in poor glycemic control with episode severity. Prolonged episode duration also exhibited a statistically significant association with more severity. Gastrointestinal symptoms were commonly reported during the presentation. Moreover, several clinical signs and symptoms, including decreased consciousness, reduced activity, drowsiness, Kussmaul breathing, shortness of breath, vomiting, tachycardia, and severe dehydration, were significantly correlated with the severity of DKA (<0.05). Hypernatremia was more frequent among children with severe DKA.
Diabetes ketoacidosis was observed to occur more frequently among males in middle childhood with seasonal variations. Furthermore, the severity of DKA was associated with lower economic status, early adolescence, and the presence of hypernatremia.
评估临床指标，以检查诊断为 1 型糖尿病 (T1DM) 的儿童和青少年中糖尿病酮症酸中毒 (DKA) 发作的严重程度。
回顾性分析了 2018 年至 2022 年期间因 DKA 到急诊科就诊的 156 例年龄在 6 个月至 14 岁的 T1DM 患者的数据。收集了人口统计学特征、经济状况、初始临床表现、血糖控制、DKA 严重程度和实验室评估等数据。
在儿童中期，男性患者中 DKA 发作更为常见。值得注意的是，这些发作存在季节性模式。严重程度与经济状况呈负相关，与青春期早期呈正相关。新诊断的 T1DM 患者占 52.9%，严重 DKA 与该亚组之间存在统计学显著关联。此外，随着发作严重程度的增加，血糖控制也明显恶化。发作持续时间延长也与更严重的程度呈统计学显著相关。发作期间常报告胃肠道症状。此外，意识降低、活动减少、嗜睡、库斯莫尔呼吸、呼吸急促、呕吐、心动过速和严重脱水等几种临床体征和症状与 DKA 的严重程度显著相关（<0.05）。严重 DKA 患者中更常出现高钠血症。
DKA 更常发生在儿童中期的男性中，且具有季节性变化。此外，DKA 的严重程度与较低的经济状况、青春期早期和高钠血症有关。
