Pathways to reduce diabetic ketoacidosis with new onset type 1 diabetes: Evidence from a regional pediatric diabetes center: Auckland, New Zealand, 2010 to 2014

Show simple item record Gunn, ER en Albert, Benjamin en Hofman, Paul en Cutfield, Wayne en Gunn, Alistair en Jefferies, CA en Starbase Diabetes Working Group, Paediatric Diabetes Service, Starship Children's Hospital, Auckland, New Zealand en
dc.coverage.spatial Denmark en 2018-11-05T20:10:04Z en 2017-11 en
dc.identifier.citation Pediatric Diabetes 18(7):553-558 Nov 2017 en
dc.identifier.issn 1399-543X en
dc.identifier.uri 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 en
dc.rights.uri 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 en
pubs.subtype Article en
pubs.elements-id 542834 en Liggins Institute en Medical and Health Sciences en Medical Sciences en Physiology Division en
dc.identifier.eissn 1399-5448 en
pubs.record-created-at-source-date 2016-10-25 en
pubs.dimensions-id 27726271 en

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