dc.contributor.author |
Gunn, ER |
en |
dc.contributor.author |
Albert, Benjamin |
en |
dc.contributor.author |
Hofman, Paul |
en |
dc.contributor.author |
Cutfield, Wayne |
en |
dc.contributor.author |
Gunn, Alistair |
en |
dc.contributor.author |
Jefferies, CA |
en |
dc.contributor.author |
Starbase Diabetes Working Group, Paediatric Diabetes Service, Starship Children's Hospital, Auckland, New Zealand |
en |
dc.coverage.spatial |
Denmark |
en |
dc.date.accessioned |
2018-11-05T20:10:04Z |
en |
dc.date.issued |
2017-11 |
en |
dc.identifier.citation |
Pediatric Diabetes 18(7):553-558 Nov 2017 |
en |
dc.identifier.issn |
1399-543X |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/43940 |
en |
dc.description.abstract |
BACKGROUND: There has been little change in the incidence of diabetic ketoacidosis (DKA) in newly diagnosed type 1 diabetes mellitus (T1DM) in children and adolescents in most developed countries. OBJECTIVES: To assess potentially modifiable antecedents of DKA in children <15 years of age with new onset T1DM. METHODS: Retrospective review of prospectively collected data from a complete regional cohort of children with T1DM in Auckland (New Zealand) from 2010 to 2014. DKA and severity were defined according to the ISPAD 2014 guidelines. RESULTS: A total of 263 children presented with new onset T1DM during the 5-year study period at 9.0 years of age (range 1.0-14.7), of whom 61% were NZ-European, 14% Maori, 13% Pacifica, and 11% other. A total of 71 patients (27%) were in DKA, including 31 mild, 20 moderate, and 20 severe DKA. DKA was associated with no family history of T1DM, higher glycated hemoglobin (HbA1c) values at presentation, self-presenting to secondary care, health care professional contacts in the 4 weeks before final presentation, and greater deprivation. Although a delay in referral from primary care for laboratory testing was common (81/216), only delay for more than 48 hours was associated with increased risk of DKA (11/22 > 48 h vs 12/59 referred at <48 h, P = .013). CONCLUSIONS: These data suggest that in addition to lack of family awareness potentially modifiable risk factors for new onset DKA include prolonged delay for laboratory testing and a low index of medical suspicion for T1DM leading to delayed diagnosis. |
en |
dc.language |
ENG |
en |
dc.publisher |
Wiley |
en |
dc.relation.ispartofseries |
Pediatric Diabetes |
en |
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
en |
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.rights.uri |
https://authorservices.wiley.com/author-resources/Journal-Authors/licensing/self-archiving.html |
en |
dc.subject |
T1DM |
en |
dc.subject |
children |
en |
dc.subject |
diabetic ketoacidosis |
en |
dc.subject |
insulin |
en |
dc.title |
Pathways to reduce diabetic ketoacidosis with new onset type 1 diabetes: Evidence from a regional pediatric diabetes center: Auckland, New Zealand, 2010 to 2014 |
en |
dc.type |
Journal Article |
en |
dc.identifier.doi |
10.1111/pedi.12456 |
en |
pubs.issue |
7 |
en |
pubs.begin-page |
553 |
en |
pubs.volume |
18 |
en |
dc.rights.holder |
Copyright: Wiley |
en |
dc.identifier.pmid |
27726271 |
en |
pubs.end-page |
558 |
en |
pubs.publication-status |
Published online |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/OpenAccess |
en |
pubs.subtype |
Article |
en |
pubs.elements-id |
542834 |
en |
pubs.org-id |
Liggins Institute |
en |
pubs.org-id |
Medical and Health Sciences |
en |
pubs.org-id |
Medical Sciences |
en |
pubs.org-id |
Physiology Division |
en |
dc.identifier.eissn |
1399-5448 |
en |
pubs.record-created-at-source-date |
2016-10-25 |
en |
pubs.dimensions-id |
27726271 |
en |