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Difference in the duration of pediatric diabetic ketoacidosis: Comparison of new‐onset to known type 1 diabetes
Author(s) -
ValeroGuzmán Leonardo,
VásquezHoyos Pablo,
CamachoCruz Jhon,
MayaHijuelos Luis Carlos,
MartínezLozada Susan,
RubianoAcevedo Ana María,
LaraBernal Marleny,
DiazAngarita Tomas
Publication year - 2020
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.13007
Subject(s) - medicine , diabetic ketoacidosis , type 1 diabetes , diabetes mellitus , retrospective cohort study , complication , cohort , ketoacidosis , type 2 diabetes , pediatrics , insulin , endocrinology
Objective To compare the duration (hours until HCO 3 ‐ ≥ 15 mmol/L) of diabetic ketoacidosis (DKA) episodes that are the first manifestation of new type 1 diabetes (NT1D) and those that are a complication in patients with previously diagnosed type 1 diabetes (PT1D). Methods A multicenter retrospective cohort study was designed. The duration of DKA was measured from the start of the treatment. The primary outcome was the comparison of the time needed in each group to reach HCO 3 ‐ ≥ 15 mmol/L. The secondary outcomes were the comparison of the time to reach pH ≥ 7.3 and length of hospital stay in each group. Data were analyzed with a bivariate analysis of the variables vs primary outcome. Then, a regression model was analyzed. Results There were 305 episodes included (NT1D: 115, PT1D: 190). DKA in the NT1D group lasted longer (NT1D 20 (16‐19) vs PT1D 12 (8‐16), hours, P < .01) with a significant difference in each level of DKA severity. This group also took longer to reach pH ≥ 7.3 (NT1D 16 (12‐22) vs PT1D 9 (6‐12), hours, P < .01) and had a longer hospital stay (NT1D 9 (6‐12) vs PT1D 7 (4‐10), hours, P < .01).Conclusion The duration of DKA is longer in patients with NT1D regardless of characteristics like DKA severity, duration of symptoms, and type of treatments received.