title: Ketoacidosis at first presentation of type 1 diabetes mellitus among children: a study from Kuwait.
abstract: We examined the frequency and severity of diabetic ketoacidosis (DKA) in 679 children and adolescents (0-14 years) at diagnosis of Type 1 Diabetes Mellitus (T1DM) in Kuwait. Between 1(st) January 2011 and 31(st) December 2013, all newly diagnosed children with diabetes were registered prospectively in a population-based electronic register. DKA was diagnosed using standard criteria based on the levels of venous pH and serum bicarbonate. At the time of diagnosis, mild/moderate DKA was present in 24.8% of the children, while severe DKA was present in 8.8%. Incidence of ketoacidosis was significantly higher in young children less than 2 (60.7% vs 32.4% p = <0.005) compared to children 2-14 years old, and a higher proportion presented with severe DKA (21.4% vs 8.3% p = <0.05). No association was seen with gender. Significant differences were found in the incidence of DKA between Kuwaiti and non-Kuwaiti children (31.1% vs 39.8%; p < 0.05). Family history of diabetes had a protective effect on the occurrence of DKA (OR = 0.44; 95% CI = 0.27-0.71). Incidence of DKA in children at presentation of T1DM remains high at 33.6%. Prevention campaigns are needed to increase public awareness among health care providers, parents and school teachers in Kuwait.
authors.affiliation: Dasman Diabetes Institute, Pediatric Research Unit, Capital 15462 Kuwait.
authors.forename: Azza Aly
authors.initials: AA
authors.lastname: Shaltout
authors.affiliation: Dasman Diabetes Institute, Department of Integrative Informatics, Capital 15462 Kuwait.
authors.forename: Arshad Mohamed
authors.initials: AM
authors.lastname: Channanath
authors.affiliation: Dasman Diabetes Institute, Department of Integrative Informatics, Capital 15462 Kuwait.
authors.forename: Thangavel Alphonse
authors.initials: TA
authors.lastname: Thanaraj
authors.affiliation: Dasman Diabetes Institute, Pediatric Research Unit, Capital 15462 Kuwait.
authors.forename: Dina
authors.initials: D
authors.lastname: Omar
authors.affiliation: Faculty of Medicine, Kuwait University, Jabriya 13110 Kuwait.
authors.forename: Majedah
authors.initials: M
authors.lastname: Abdulrasoul
authors.affiliation: Adan Hospital, Department of Pediatrics, Ahmadi 52853 Kuwait.
authors.forename: Nabila
authors.initials: N
authors.lastname: Zanaty
authors.affiliation: Adan Hospital, Department of Pediatrics, Ahmadi 52853 Kuwait.
authors.forename: Maria
authors.initials: M
authors.lastname: Almahdi
authors.affiliation: Farwaniya Hospital, Department of Pediatrics, Farwaniya 81004 Kuwait.
authors.forename: Hessa
authors.initials: H
authors.lastname: Alkandari
authors.affiliation: Faculty of Medicine, Kuwait University, Jabriya 13110 Kuwait.
authors.forename: Dalia
authors.initials: D
authors.lastname: AlAbdulrazzaq
authors.affiliation: Dasman Diabetes Institute, Pediatric Research Unit, Capital 15462 Kuwait.
authors.forename: Linda
authors.initials: L
authors.lastname: d'Mello
authors.affiliation: Sabah Hospital, Department of Pediatrics, 90801 Kuwait.
authors.forename: Fawziya
authors.initials: F
authors.lastname: Mandani
authors.affiliation: Jahra Hospital, Department of Pediatrics, 1753 Jahra, Kuwait.
authors.forename: Ayed
authors.initials: A
authors.lastname: Alanezi
authors.affiliation: Mubarak Hospital, Department of Pediatrics, 43787, Hawalli, Kuwait.
authors.forename: Eman
authors.initials: E
authors.lastname: AlBasiry
authors.affiliation: Amiri Hospital, Department of Pediatrics, Capital 13041 Kuwait.
authors.forename: M
authors.initials: M
authors.lastname: Alkhawari
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000473:pathology*; D016883:Diabetic Ketoacidosis / Q000175:diagnosis* / Q000473:pathology*; D005260:Female; D006282:Health Personnel; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007730:Kuwait; D008297:Male; D011446:Prospective Studies; D012042:Registries