title: Ethnicity and young age influence the frequency of diabetic ketoacidosis at the onset of type 1 diabetes.
abstract: Diabetic ketoacidosis (DKA) may be present at the onset of type 1 diabetes (T1D), increasing both its morbidity and mortality. The aim of this study was to describe the frequency of this complication at the clinical presentation of T1D, as well as possible interfering factors in a multi-ethnic population from Brazil. We have reviewed the medical charts of 545 individuals with T1D diagnosed between 1968 and 2006 from two major local diabetes treatment centers. DKA occurred in 179 patients (32.8%) at the onset of T1D. The frequency of DKA was higher in non-white than white individuals (p<0.0001) and in the younger age groups (<or=5 y/o and 6-10 y/o; p=0.015). The prevalence of DKA at the onset of the disease did not change over the past four decades, except for a higher prevalence in patients diagnosed since 2000 when compared to those that had hyperglycemia detected in the 1990s (p=0.019). To conclude, a significant proportion of individuals present DKA at the onset of T1D in this population, especially very young children and non-white individuals. Unfortunately, the frequency of DKA has not progressively declined in the past decades. An improvement in the educational programs for detection of early signs and symptoms might help to change this scenario.
authors.affiliation: Federal University of Rio de Janeiro, Adult Diabetes Section, Brazil. mrodacki@hucff.ufrj.br
authors.forename: Melanie
authors.initials: M
authors.lastname: Rodacki
authors.forename: Joana Rodrigues Dantas
authors.initials: JR
authors.lastname: Pereira
authors.forename: Aline Moreira
authors.initials: AM
authors.lastname: Nabuco de Oliveira
authors.forename: Bianca
authors.initials: B
authors.lastname: Barone
authors.forename: Renata
authors.initials: R
authors.lastname: Mac Dowell
authors.forename: Paula
authors.initials: P
authors.lastname: Perricelli
authors.forename: Michelle Telles
authors.initials: MT
authors.lastname: Bravo
authors.forename: Marcus Miranda
authors.initials: MM
authors.lastname: de Oliveira
authors.forename: Julia Dias
authors.initials: JD
authors.lastname: Brum
authors.forename: Luciana Camara
authors.initials: LC
authors.lastname: Belem
authors.forename: Phelipe Guimarães
authors.initials: PG
authors.lastname: de Ornellas
authors.forename: Renata Szundy
authors.initials: RS
authors.lastname: Berardo
authors.forename: Jorge
authors.initials: J
authors.lastname: Luescher
authors.forename: Ludmila
authors.initials: L
authors.lastname: Campos
authors.forename: Andrea de Menezes
authors.initials: Ade M
authors.lastname: Vangelotti
authors.forename: Rosane
authors.initials: R
authors.lastname: Kupfer
authors.forename: Lenita
authors.initials: L
authors.lastname: Zajdenverg
authors.forename: Adolpho
authors.initials: A
authors.lastname: Milech
authors.forename: Jose Egidio
authors.initials: JE
authors.lastname: Paulo de Oliveira
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D044383:Black People; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000208:ethnology*; D016883:Diabetic Ketoacidosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D044465:White People