The Incidence and Severity of Paediatric Diabetic Ketoacidosis Presenting to a Metropolitan Hospital in Western Sydney: A 10-Year Retrospective Review.

Abstract

Objectives: To report the incidence and clinical characteristics of paediatric patients presenting with diabetic ketoacidosis to the Emergency Department (ED) with new and pre-existing type 1 diabetes mellitus (T1DM).

Methodology: A ten-year retrospective data analysis was performed on children under 16 years presenting to the ED with T1DM from January 2010. Demographic and laboratory data were extracted to determine the rates of DKA. Comparative statistics were performed between age groups and pre-existing and newly diagnosed T1DM patients.

Results: A total of 196 children with T1DM were included. The mean age of the cohort was 9.3 ± 4.0 years, with female predominance (54%, p = 0.38). Most (60%) were newly diagnosed with T1DM, of which 38% presented in DKA. Amongst the total cohort, 43% presented in DKA.The older children accounted for 50% of the DKA presentations in the newly diagnosed cohort. Amongst the younger age group, 42% presented with severe DKA. There were higher rates of T1DM in areas of relative socioeconomic advantage.

Conclusion: Children with T1DM presented with unacceptably high rates of DKA and posed a significant medical, psychosocial and financial burden on families and medical services. These findings suggest that a prospective public health campaign to reduce rates of DKA is warranted.