title: [Epidemiology and clinical course of diabetic ketoacidosis in children and adolescents with type 1 diabetes mellitus].
abstract: BACKGROUND
  Despite the progress in diagnosis and treatment of type 1 diabetes, diabetic ketoacidosis (DKA) is still a serious clinical problem. The aim of the study was too describe the epidemiology and clinical characteristic of DKA in children and adolescents with type 1 diabetes.
  
  
  METHODS
  Medical records of 650 patients with type 1 diabetes who were under care of the Outpatient Clinic for Diabetic Children of the Medical University of Lodz from 1st January 2007 till 31 December 2009 were analysed.
  
  
  RESULTS
  101 cases of DKA were reported; the incidence of DKA was 5.2/100 patients /year. Episodes of DKA occurred in 89 patients (39 girls and 50 boys). In 82 patients 1 episode of DKA was recorded, in 3 patients - 2 episodes, in 3 patients - 3 episodes and in 1 patient - 4 episodes. 58.4% (59/101) of DKA episodes occurred in patients with newly diagnosed diabetes (mean age: 8.04-4.78 years) and 41.6% (42/101) - in children with established type 1 diabetes (mean age: 13.3-3.37). DKA was diagnosed in 26,1% of children with new onset of the disease. The most frequent causes of DKA in patients with established type 1 diabetes were noncompliance (22/42) and acute infectious diseases (12/42). Severe DKA was diagnosed in 19/101 episodes, moderate - in 36/101 and mild - in 46/101. No lethal complication of DKA was recorded. The following complications of DKA were observed: dyselectrolitemia (68/101), acute pancreatitis (5/101), gastrorrhagia (1/101), insulin oedema (1/101). Mean duration of hospitalization was 12.03-5.58 days.
  
  
  CONCLUSIONS
  Newly diagnosed type 1 diabetes is the main cause of DKA in children and adolescents.In established type 1 diabetes the most frequent cause of DKA is poor quality of self-management. Dyselectrolitemia is the most frequent complication of DKA in children. Acute pancreatitis should be considered in a young patient with DKA.
authors.forename: Iwona
authors.initials: I
authors.lastname: Pietrzak
authors.forename: Beata
authors.initials: B
authors.lastname: Mianowska
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Zmysłowska
authors.forename: Wojciech
authors.initials: W
authors.lastname: Fendler
authors.forename: Wojciech
authors.initials: W
authors.lastname: Młynarski
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Szadkowska
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000453:epidemiology; D016883:Diabetic Ketoacidosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011044:Poland / Q000453:epidemiology