Diabetic Ketoacidosis in Type 1 Diabetes Onset in Latin American Children

To describe the patterns of diabetic ketoacidosis (DKA) occurrence in children newly diagnosed with type 1 diabetes (T1DM) across several Latin American pediatric diabetes centers from 2018 to 2022. A retrospective chart review included children under 18 with new-onset T1DM from 30 Latin American pe...

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Published in:	Journal of pediatric health care Vol. 38; no. 4; pp. 544 - 551
Main Authors:	Hirschler, Valeria, Gonzalez, Claudio D., Krochik, Gabriela, Rousos, Adriana M., Andres, Maria E., Riera, Francisca, Ibarcena, Paola Pinto, Molinari, Claudia, Porta, Luis F. Palacios, Prieto, Mariana, Mateu, Carolina Martinez, Barcala, Consuelo, Arrigo, Maria A., Tachetti, Jacqueline, Raggio, Marcela, Vacarezza, Veronica, Major, Maria L., Sobrero, Angela Figueroa, Bogado, Ernesto, Lopez, Stella, Povedano, Paula Paz, Scaiola, Edit, Leiva, Fabiana, Pacheco, Gabriela, Pasayo, Patricia, Dupuy, Mariana, Torossi, Maria B., Benitez, Amanda J., Marassi, Andrea Escalante, Caballero, Zulema, Garcia, Ana L., Mazzetti, Sandra, Pugliese, Maria I. Ruiz, Gonzalez, Diana S., Grabois, Florencia, Villar, Carlos M Del Aguila, Flores, Adriana B.
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-07-2024
Subjects:	Adolescent Child Child, Preschool Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 1 - epidemiology Diabetic ketoacidosis Diabetic Ketoacidosis - diagnosis Diabetic Ketoacidosis - epidemiology Female Humans Latin America - epidemiology Latin American children Logistic Models Male onset type 1 diabetes Retrospective Studies Latin America onset type 1 diabetes Diabetic ketoacidosis Latin American children
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Summary:	To describe the patterns of diabetic ketoacidosis (DKA) occurrence in children newly diagnosed with type 1 diabetes (T1DM) across several Latin American pediatric diabetes centers from 2018 to 2022. A retrospective chart review included children under 18 with new-onset T1DM from 30 Latin American pediatric diabetes centers (Argentina, Chile, and Peru) between 30 December 2018 and 30 December 2022. Multiple logistic regression models examined the relationships between age, gender, medical insurance, BMI, and DKA at new-onset T1DM. As far as we know, there are no large studies in Latin American countries exploring the patterns of DKA in new-onset T1DM. A total of 2,026 (983 females) children, median age 9.12 (5.8 -11.7) years with new-onset-T1DM were included. Approximately 50% had no medical insurance. Mean glucose values were 467 mg/dL, pH 7.21, bicarbonate 13 mEq/L, HbA1c 11.3%, and BMI 18. The frequency of DKA was 1,229 (60.7%), out of which only 447 (36%) were severe. There was a significant decrease in the frequency of DKA as age increased: 373 (70.2%) in children under 6, 639 (61.6%) in those between 6 and 12, 217 and (47.5%) in those over 12. Children with medical insurance (58.8%) had a significantly lower frequency of DKA than those without (62.7%). The multiple logistic regression models showed that DKA was significantly and inversely associated with age [OR, 0.72 (95% CI 0.60–0.86)], BMI [OR, 0.95 (95% CI 0.92–0.99)], and medical insurance [OR, 0.75 (95% CI 0.60–0.94)] adjusted for sex. Latin American children with new-onset T1DM exhibited a substantial occurrence of DKA. Younger ages and the lack of medical insurance were significantly associated with DKA in new-onset T1DM.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0891-5245 1532-656X 1532-656X
DOI:	10.1016/j.pedhc.2024.01.006