#34 Diabetic Ketoacidosis at Presentation of Type 1 Diabetes in Children
Rachel Kesselman, University of Manitoba; Elizabeth Sellers, University of Manitoba/ Children’s Hospital Research Insitute of Manitoba
Diabetic ketoacidosis (DKA) causes significant morbidity and mortality in children with type 1 diabetes. The objectives of this study are to describe (1) the frequency of DKA at diagnosis of type 1 diabetes in children (0-18 years) in Manitoba and (2) the characteristics of children who present in DKA.
A retrospective review of the pediatric provincial database was performed for a 2 year period (2015-2016). DKA was defined as a pH<7.30. Data extracted from time of diagnosis included presentation in DKA, age, sex, A1c, rural/ urban residence, type of primary care provider, and contact with a healthcare professional (HCP) in the 2 weeks preceding DKA. Descriptive statistics were employed.
55/158 (34.8%) newly diagnosed children presented with DKA. Mean age and A1c, gender and % rural residence did not differ between those presenting in DKA and those not. Of those with DKA, 29% had prior contact with a HCP. A1c was significantly higher in those who had prior contact with a HCP (13.0% vs 11.8%, p=0.05). Mean age, % rural residence; sex and type of care provider did not differ between those who had contact with a HCP prior to presentation in DKA compared to those without contact.
The frequency of DKA at presentation of type 1 diabetes in Manitoba is high. It is likely that a public health approach combined with education of HCP’s will be necessary to decrease DKA at presentation in children with type 1 diabetes in Manitoba.