GA/HbA1c Ratio Predicts the Occurrence of Diabetic Ketoacidosis and Disease Severity in Children with Type 1 Diabetes Mellitus.

Abstract

Background: Pediatric type 1 diabetes mellitus (T1DM) is a significant endocrine condition, with diabetic ketoacidosis (DKA) posing a life-threatening risk. The aim of this study was to investigate the potential of the glycated albumin (GA) to glycosylated hemoglobin (HbA1c) ratio in predicting the occurrence of DKA and disease severity in children with T1DM.

Methods: In this study, 224 children with T1DM were retrospectively analyzed and divided into non-DKA group (n = 142) and DKA group (n = 82). The patients' GA and HbA1c levels as well as other related biochemical indexes were detected, and the GA/A1c ratio was calculated and analyzed for its correlation with the occurrence of DKA and disease severity. Meanwhile, the value of GA/A1c ratio in predicting DKA was evaluated by using the receiver operating characteristic curve and the area under the curve.

Results: In the DKA group, both GA and GA/A1c ratio were elevated, and patients with severe DKA had especially high GA/A1c ratio. GA/A1c ratio was effective in clinically predicting the occurrence and severity of DKA. Increased GA and GA/A1c ratio correlated with the high risk of DKA in T1DM patients. For T1DM patients, a greater GA/A1c ratio indicated a higher risk of DKA compared to GA. There was a linear relationship between GA/A1c ratio and DKA, and when the GA/A1c ratio was greater than 2.465, an increase in the GA/A1c ratio was positively correlated with a significant increase in the risk of developing DKA in T1DM.

Conclusions: GA/A1c ratio can be used as an effective indicator to predict the occurrence of DKA and its severity in pediatric T1DM patients, and the higher the GA/A1c ratio, the higher the risk of DKA and the severity of the disease in patients.