title: Factors Associated with the Presence and Severity of Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes in Korean Children and Adolescents.
abstract: The aim of this study was to identify the risk factors for presence and severity of diabetic ketoacidosis (DKA) at the onset of type 1 diabetes mellitus (T1DM) in Korean children and adolescents. A retrospective chart review of children and adolescents newly diagnosed with T1DM was conducted in seven secondary and tertiary centers in Korea. Eligible subjects were < 20 years of age and had records on the presence or absence of DKA at the time of T1DM diagnosis. DKA severity was categorized as mild, moderate, or severe. Data were collected on age, height, body weight, pubertal status, family history of diabetes, delayed diagnosis, preceding infections, health insurance status, and parental education level. A total of 361 patients (male 46.3%) with T1DM were included. Overall, 177 (49.0%) patients presented with DKA at T1DM diagnosis. Risk factors predicting DKA at T1DM diagnosis were age ≥ 12 years, lower serum C-peptide levels, presence of a preceding infection, and delayed diagnosis. Low parental education level and preceding infection increased the severity of DKA. These results suggest that alertness of the physician and public awareness of diabetes symptoms are needed to decrease the incidence and severity of DKA at T1DM diagnosis.
authors.affiliation: Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hye Jin
authors.identifier: http://orcid.org/0000-0002-7925-5238
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hyeoh Won
authors.identifier: http://orcid.org/0000-0002-7224-400X
authors.initials: HW
authors.lastname: Yu
authors.affiliation: Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: Hae Woon
authors.identifier: http://orcid.org/0000-0003-0494-4626
authors.initials: HW
authors.lastname: Jung
authors.affiliation: Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Young Ah
authors.identifier: http://orcid.org/0000-0001-9179-1247
authors.initials: YA
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
authors.forename: Jae Hyun
authors.identifier: http://orcid.org/0000-0002-0203-7443
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Hye Rim
authors.identifier: http://orcid.org/0000-0001-8550-4969
authors.initials: HR
authors.lastname: Chung
authors.affiliation: Department of Pediatrics, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Jaeho
authors.identifier: http://orcid.org/0000-0003-3065-944X
authors.initials: J
authors.lastname: Yoo
authors.affiliation: Department of Pediatrics, Chosun University Hospital, Chosun University College of Medicine, Gwangju, Korea.
authors.forename: Eunyoung
authors.identifier: http://orcid.org/0000-0002-3073-5222
authors.initials: E
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Jeesuk
authors.identifier: http://orcid.org/0000-0003-0020-2000
authors.initials: J
authors.lastname: Yu
authors.affiliation: Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Choong Ho
authors.identifier: http://orcid.org/0000-0002-9813-1134
authors.initials: CH
authors.lastname: Shin
authors.affiliation: Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Sei Won
authors.identifier: http://orcid.org/0000-0002-5304-5750
authors.initials: SW
authors.lastname: Yang
authors.affiliation: Department of Pediatrics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea. gnoygnoes@hanmail.net.
authors.forename: Seong Yong
authors.identifier: http://orcid.org/0000-0002-7077-869X
authors.initials: SY
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D044466:Asian People; D001835:Body Weight; D002096:C-Peptide / Q000097:blood; D002648:Child; D002675:Child, Preschool; D057210:Delayed Diagnosis; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis*; D016883:Diabetic Ketoacidosis / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D062606:Tertiary Care Centers
chemical_list: D002096:C-Peptide; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Diabetic Ketoacidosis; Risk Factors; Type 1 Diabetes Mellitus