Abstract.
Aims/hypothesis:
We aimed to describe the frequency and degree of diabetic ketoacidosis in children across Europe at the time of diagnosis of Type I (insulin-dependent) diabetes mellitus and to determine if factors such as age and geographical region contribute to the risk of diabetic ketoacidosis.
Methods:
The study was part of the EURODIAB project. A total of 24 centres, covering a population at risk of more than 15 million children below 15 years of age, recruited 1 260 children at the time of clinical diagnosis.
Results:
Polyuria, by far the most frequent symptom, was observed in 96 % of the children. In only 25 % of the children was the duration of symptoms less than 2 weeks and this proportion was larger in the under 5 year age-group (37 vs 22 %; p < 0. 001). Of the 11 centres that recorded diabetic ketoacidosis status, the overall proportion with diabetic ketoacidosis (pH < 7.3) was 40 % (95 %-CI : 36–44 %) in at least 90 % of cases. After stratification by centre, the odds ratio for diabetic ketoacidosis in the under 5 age-group was 1.02 (95 %-CI : 0.69–1.49) relative to the older children. There was significant variation between the 11 centres in the frequency of diabetic ketoacidosis which ranged from 26 to 67 % (p = 0.002). An inverse correlation between the frequency of diabetic ketoacidosis and the background incidence rate was found in these centres (Spearman's rank correlation, r s = –0.715; p = 0.012).
Conclusion/interpretation:
Rising standards of medical information and greater awareness concurrent with an overall increase in incidence could have resulted in changes in the clinical presentation at onset of Type I childhood diabetes in Europe. [Diabetologia (2001) 44 [Suppl 3]: B 75–B 80]
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Lévy-Marchal, C., Patterson, C., Green, A. et al. Geographical variation of presentation at diagnosis of Type I diabetes in children: the EURODIAB Study. Diabetologia 44 (Suppl 3), B75–B80 (2001). https://doi.org/10.1007/PL00002958
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DOI: https://doi.org/10.1007/PL00002958