title: Predictors of diabetic ketoacidosis in children and adolescents with type 1 diabetes. Experience from a large multicentre database.
abstract: OBJECTIVE
  Diabetic ketoacidosis (DKA) remains a major cause of hospitalization and death in children and adolescents with established type 1 diabetes despite DKA preventing strategies. The aim of the study was to determine incidence and risk factors for DKA in a large cohort of young diabetic patients.
  
  
  METHODS
  This investigation uses the dpv-wiss base containing data on 28 770 patients with type 1 diabetes <20yr, from Germany and Austria. For each patient the most recent year of follow-up was evaluated. DKA was defined as pH < 7.3 and/or hospital admission as a result of DKA, excluding onset DKA.
  
  
  RESULTS
  Mean age of the study cohort was 13.96 ± 4.0 yr (47.9% females). A total of 94.1% presented with no episode, 4.9% with 1 episode, and 1.0% with recurrent DKA (≥2). When comparing these three groups, age (p < 0.01), HbA1c (p < 0.01), and insulin dose (p < 0.01) were significantly higher in patients with recurre nt DKA. Incidence of DKA was significantly higher in females (7.3 ± 0.5 vs. 5.8 ± 0.2; p = 0.03) and in patients with migration background (7.8 ± 0.6 vs. 6.3 ± 0.3; p = 0.02). No significant association was found with treatment type and diabetes duration.
  
  
  CONCLUSIONS
  In a cohort of European paediatric diabetic patients, the rate of DKA was significantly higher in females and in children with migration background and early teenage years.
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria. maria.fritsch@meduniwien.ac.at
authors.forename: Maria
authors.initials: M
authors.lastname: Fritsch
authors.forename: Joachim
authors.initials: J
authors.lastname: Rosenbauer
authors.forename: Edith
authors.initials: E
authors.lastname: Schober
authors.forename: Andreas
authors.initials: A
authors.lastname: Neu
authors.forename: Kerstin
authors.initials: K
authors.lastname: Placzek
authors.forename: Reinhard W
authors.initials: RW
authors.lastname: Holl
mesh_terms: D000293:Adolescent; D000367:Age Factors; D017668:Age of Onset; D001317:Austria / Q000453:epidemiology; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000453:epidemiology*; D016883:Diabetic Ketoacidosis / Q000453:epidemiology*; D004641:Emigration and Immigration; D005260:Female; D005858:Germany / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D015994:Incidence; D007328:Insulin / Q000627:therapeutic use; D008297:Male
chemical_list: D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human