Difference in the Duration of Pediatric Diabetic Ketoacidosis: Comparison of New‐onset to Known Type 1 Diabetes
First published:17 March 2020
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/pedi.13007.
Peer Review The peer review history for this article is available at https://publons.com/publon/10.1111/pedi.13007.
ABSTRACT
Objective
To compare the duration (hours until HCO3− ≥ 15 mmol/L) of diabetic ketoacidosis (DKA) episodes that are the first manifestation of new type 1 diabetes (NT1D) and those that are a complication in patients with known type 1 diabetes (PT1D).
Methods
A multicenter retrospective cohort study was designed. The duration of DKA was measured from the start of the treatment. The primary outcome was the comparison of the time needed in each group to reach HCO3− ≥ 15 mmol/L. The secondary outcomes were the comparison of the time to reach pH ≥7.3 and length of hospital stay in each group. Data was analyzed with a bivariate analysis of the variables vs primary outcome. Then, a regression model was analyzed. Results: There were 305 episodes included (NT1D: 115, PT1D: 190). DKA in the NT1D group lasted longer (NT1D 20 (16‐19) vs PT1D 12 (8‐16), hours, P < 0.01) with a significant difference in each level of DKA severity. This group also took longer to reach pH ≥7.3 (NT1D 16 (12‐22) vs PT1D 9 (6‐12), hours, P < 0.01) and had a longer hospital stay (NT1D 9 (6‐12) vs PT1D 7 (4‐10), hours, P < 0.01).
Conclusion
The duration of DKA is longer in patients with NT1D regardless of characteristics like DKA severity, duration of symptoms and type of treatments received.
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