Risk Factors of Recurrent Diabetic Ketoacidosis among Children and Adolescents with Type 1 Diabetes Mellitus
Keywords:
Daiabetes Mellitus, Type 1, Recurrent Diabetic Ketoacidosis, Risk FactorsAbstract
Background: Diabetic ketoacidosis is an acute dangerous complication of DM, which happens mostly in those patients with T1DM, and can occur in those patients with other types of diabetes under certain conditions.
Objectives: This analytic study try to identify the precipitating factors of the recurrent DKA in our patients, to decrease morbidity and mortality, decrease admissions to the emergency units and decrease heavy burden of the patients and their families.
Patients & Methods: The study included patients with Type I Diabetes Mellitus who were admitted to the emergency unit, endocrinology ward, and patients attended out-patient diabetic clinic at central teaching hospital for children, Baghdad, from the 1st of September 2019 till the end of October 2020. A written informed consent had been taken from the relative of the patients, for each patient detailed history and examination was taken regarding; Personal information, regimen of insulin and daily insulin requirement, family knowledge about diabetes management, educational level and the socioeconomic status of the family, family history of diabetes mellitus, illness and vaccinations, compliance to the management and follow-up.
Conclusions: Gender, recent illness with inappropriate management, lipohypertrophy, educational level of the mothers, psychiatric illness especially depression and anxiety, irregular follow up visits, high HbA1c and bad dietary adherence were associated with recurrent DKA. While frequency of DKA wasn’t related with age of the patients, duration of DM, types of insulin regimens, daily insulin requirement, family hx. of DM, usual vaccination schedule, socioeconomic status and autoimmune disease e.g. (celiac disease and hypothyroidism).
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