Abstract

Background: Type 1 diabetes is a growing disease worldwide, where ketoacidosis is a serious cause commonly resulting in hospitalization. Little is known regarding the epidemiology of the development of ketoacidosis in Colombian children with a known diagnosis of diabetes.

Objective: To describe the epidemiological profile of children with type 1 diabetes and ketoacidosis diagnosis.

Settings: Using the online survey, http://www.e-encuesta.com/answer.do?testid=cRctXSlVSLk, seven pediatric intensive care units of the four main cities throughout the country reported epidemiological data of the patients that were admitted with episodes of ketoacidosis other than diabetes debut, between May of 2014 and May of 2016.

Measurement and main results: Fifty-two events of diabetic ketoacidosis in 47 patients between ages 3 and 17 were included. The patients had mean glycosylated hemoglobin of 12% (SD: 2.9) and the median insulin dose used was 0.91 (IQR 0.74 – 1.2 UI/kg). One hundred percent of patients belonged to middle and low socioeconomic classes, 98.1% of patients were insured by the health care system, and 27.4% of patients did not have the necessary supplies for glucose control.

Conclusion: The glycosylated hemoglobin levels can evidence that diabetic ketoacidosis patients were generally not well controlled prior to admission. The most common precipitating factors of diabetic ketoacidosis were the low adherence to treatment and infections. Patients must be informed about the importance of adherence to treatment and how to adjust insulin on sick days; the health care system must ensure patients have the supplies necessary for optimal diabetes control. 

Keywords

Type 1 diabetes mellitus, Diabetic ketoacidosis, Risk factors, Pediatric intensive care units, Epidemiology, Multicenter studies