title: A diabetes awareness  campaign prevents diabetic ketoacidosis in children at their initial presentation with type 1 diabetes.
abstract: OBJECTIVE
  To evaluate the effect of a diabetes awareness campaign on the incidence of diabetic ketoacidosis (DKA) at the first presentation of type 1 diabetes in children (0-18 yr).
  
  
  METHODS
  This study was a controlled population intervention study with a 2-yr baseline period and a 2-yr intervention period. Data were collected on all children presenting with their initial diagnosis of type 1 diabetes [pH, bicarbonate, base excess, blood glucose level (BGL), urea, and creatinine] at Gosford, Newcastle, and Sydney (Sydney Children's Hospital and Royal North Shore Hospital). During the intervention period, diabetes education occurred in the intervention region (Gosford). Child care centers, schools, and doctor's offices were offered education and posters about the symptoms of type 1 diabetes. Doctor's offices were given glucose and ketone testing equipment. The control regions (Newcastle and Sydney) did not receive any educational intervention or test equipment. DKA was defined as pH < 7.3 or bicarbonate < 15 mmol/L.
  
  
  RESULTS
  In Gosford, the proportion of children presenting in DKA decreased from 37.5% (15/40) during the 2-yr baseline period to 13.8% (4/29) during the 2-yr intervention (p < 0.03). There was no significant change in the control regions during the same time periods, 37.4% (46/123) and 38.6% (49/127), respectively. In Gosford, the average BGL at presentation was 27.5 mmol/L during the baseline and 21.2 mmol/L during the intervention (p < 0.01).
  
  
  CONCLUSIONS
  During the diabetes awareness campaign, the rate of DKA at initial diagnosis of type 1 diabetes in children decreased by 64%.
authors: Department of Diabetes and Endocrinology, John Hunter Children's Hospital, Newcastle, NSW, Australia. bruce.king@hnehealth.nsw.gov.au
authors: Bruce R
authors: BR
authors: King
authors: Neville J
authors: NJ
authors: Howard
authors: Charles F
authors: CF
authors: Verge
authors: Michelle M
authors: MM
authors: Jack
authors: Natalie
authors: N
authors: Govind
authors: Karen
authors: K
authors: Jameson
authors: Angela
authors: A
authors: Middlehurst
authors: Lilian
authors: L
authors: Jackson
authors: Melinda
authors: M
authors: Morrison
authors: Dm Wajira S
authors: DW
authors: Bandara
mesh_terms: D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D001786:Blood Glucose / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010353:Patient Education as Topic / Q000379:methods*; D010824:Physicians' Offices; D012574:Schools
chemical_list: D001786:Blood Glucose