title: Prevalence and characteristics of type 2 diabetes mellitus in 9-18 year-old children with diabetic ketoacidosis.
abstract: OBJECTIVE
  To estimate the prevalence of type 2 diabetes mellitus (DM2) in 9-18 year-old children with diabetic ketoacidosis (DKA) and to describe the presenting biochemical characteristics and response to standardized DKA treatment.
  
  
  METHODS
  Data were collected from a consecutive sample of 9-18 year-old children presenting with DKA. DKA was defined as hyperglycemia and ketosis with an initial pH <7.3, or bicarbonate <15 mmol/l. Patients were classified as having DM2 if they had negative autoantibody status and normal or elevated fasting C-peptide.
  
  
  RESULTS
  The prevalence of DM2 in patients with DKA was 13.0% (6.1-23.3%). There was no significant difference in the presenting pH (7.14 vs 7.15), but blood glucose was higher (735 vs 587 mg/dl) in patients with DM2, than in patients with type 1 DM (DM1). The duration of insulin infusion until resolution of acidosis (17.3 vs 13.2 h) and intensive care unit stay (2.4 vs 1.6 days) were longer in patients with DM2. Seven of the nine patients with DM2 did not require insulin at 1-year follow-up.
  
  
  CONCLUSIONS
  Children with DM2 can present with DKA and constitute a significant percentage in the above 9-year age group. The need for insulin must be carefully re-evaluated as DKA resolves in these patients. Adolescents with DM2 and their families need to be educated about DKA.
authors.affiliation: Pediatric Critical Care Medicine, University of California, San Francisco, CA 94143, USA. anil.sapru@ucsf.edu
authors.forename: Anil
authors.initials: A
authors.lastname: Sapru
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Gitelman
authors.forename: Suruchi
authors.initials: S
authors.lastname: Bhatia
authors.forename: Ruth F
authors.initials: RF
authors.lastname: Dubin
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Newman
authors.forename: Heidi
authors.initials: H
authors.lastname: Flori
mesh_terms: D000293:Adolescent; D001786:Blood Glucose; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D016883:Diabetic Ketoacidosis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D005006:Ethnicity; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay; D008297:Male; D015995:Prevalence
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin