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Which Of The Following Signs And Symptoms Are Most Characteristic Of Hyperglycemic Ketoacidosis?

What Are The 3 P's Of Diabetes?

What Are The 3 P's Of Diabetes?

The 3 classic symptoms of diabetes mellitus are polyuria, polydipsia and polyphagia -- also known as the 3 P's. Polyuria, polydipsia and polyphagia are defined as an increase in urination, thirst and hunger, respectively. The presence of the 3 P’s is a good indication that your blood sugar may be too high. With type 1 diabetes (T1DM), these symptoms typically develop relatively quickly and are more obvious, often leading to diagnosis of the condition. With type 2 diabetes (T2DM), the 3 P's are often more subtle and develop more gradually. As a result, people with type 2 diabetes may overlook these symptoms, leading to a delay in diagnosis. Video of the Day The 3 P’s of diabetes are typically among the first symptoms to occur in T1DM, but they can occur with other conditions. Polyuria, or excessive urine production, can be identified by needing to urinate during the night, frequent bathroom trips or accidents in potty-trained children. Polydipsia, a consequence of polyuria, is characterized by excessive thirst. An increase in fluid intake due to polydipsia can also contribute to increased urination. Polyphagia is the term for excessive or increased hunger. It occurs with diabetes because blood sugar is fails to enter body tissues normally, leaving them short of fuel to produce energy. To compensate, fat and muscle are broken down and used for energy resulting in weight loss, lack of energy and fatigue, which are most often seen with T1DM. Signs of long-term high blood sugar, such as blurred vision and tingling or numbness in hands and feet, are more common at diagnosis with T2DM. High Blood Sugar and the 3 P's The 3 P's of diabetes all stem from high blood sugar levels. Blood sugar is normally filtered by the kidneys but then reabsorbed into the blood. When blood sug Continue reading >>

Classification, Pathophysiology, Diagnosis And Management Of Diabetes Mellitus

Classification, Pathophysiology, Diagnosis And Management Of Diabetes Mellitus

University of Gondar, Ethopia *Corresponding Author: Habtamu Wondifraw Baynes Lecturer Clinical Chemistry University of Gondar, Gondar Amhara 196, Ethiopia Tel: +251910818289 E-mail: [email protected] Citation: Baynes HW (2015) Classification, Pathophysiology, Diagnosis and Management of Diabetes Mellitus. J Diabetes Metab 6:541. doi:10.4172/2155-6156.1000541 Copyright: © 2015 Baynes HW. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Journal of Diabetes & Metabolism Abstract Diabetes Mellitus (DM) is a metabolic disorder characterized by the presence of chronic hyperglycemia either immune-mediated (Type 1 diabetes), insulin resistance (Type 2), gestational or others (environment, genetic defects, infections, and certain drugs). According to International Diabetes Federation Report of 2011 an estimated 366 million people had DM, by 2030 this number is estimated to almost around 552 million. There are different approaches to diagnose diabetes among individuals, The 1997 ADA recommendations for diagnosis of DM focus on fasting Plasma Glucose (FPG), while WHO focuses on Oral Glucose Tolerance Test (OGTT). This is importance for regular follow-up of diabetic patients with the health care provider is of great significance in averting any long term complications. Keywords Diabetes mellitus; Epidemiology; Diagnosis; Glycemic management Abbreviations DM: Diabetes Mellitus; FPG: Fasting Plasma Glucose; GAD: Glutamic Acid Decarboxylase; GDM: Gestational Diabetes Mellitus; HDL-cholesterol: High Density Lipoprotein cholesterol; HLA: Human Leucoid Antigen; IDD Continue reading >>

Hyperglycemia (high Blood Sugar)

Hyperglycemia (high Blood Sugar)

Hyperglycemia is a hallmark sign of diabetes (both type 1 diabetes and type 2 diabetes) and prediabetes. Other conditions that can cause hyperglycemia are pancreatitis, Cushing's syndrome, unusual hormone-secreting tumors, pancreatic cancer, certain medications, and severe illnesses. The main symptoms of hyperglycemia are increased thirst and a frequent need to urinate. Severely elevated glucose levels can result in a medical emergency like diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar nonketotic syndrome (HHNS, also referred to as hyperglycemic hyperosmolar state). Insulin is the treatment of choice for people with type 1 diabetes and for life-threatening increases in glucose levels. People with type 2 diabetes may be managed with a combination of different oral and injectable medications. Hyperglycemia due to medical conditions other than diabetes is generally treated by treating the underlying condition responsible for the elevated glucose. Blood Sugar Swings: Tips for Managing Diabetes & Glucose Levels A number of medical conditions can cause hyperglycemia, but the most common by far is diabetes mellitus. Diabetes affects over 8% of the total U.S. population. In diabetes, blood glucose levels rise either because there is an insufficient amount of insulin in the body or the body cannot use insulin well. Normally, the pancreas releases insulin after a meal so that the cells of the body can utilize glucose for fuel. This keeps blood glucose levels in the normal range. Type 1 diabetes is responsible for about 5% of all cases of diabetes and results from damage to the insulin-secreting cells of the pancreas. Type 2 diabetes is far more common and is related to the body's inability to effectively use insulin. In addition to type 1 and type 2, gestational diabe Continue reading >>

Clinical And Biochemical Characteristics Of Diabetes Ketoacidosis In A Tertiary Hospital In Riyadh

Clinical And Biochemical Characteristics Of Diabetes Ketoacidosis In A Tertiary Hospital In Riyadh

Go to: Introduction Diabetes is considered the fifth leading cause of death, and it is a leading cause of morbidity and mortality in the developed world, as well as in many developing countries. Diabetes prevalence (in adults) is reported to be 24% in Saudi Arabia,1 which is higher than that reported in the developed countries. According to the International Diabetes Federation, the diabetes rate in Saudi Arabia in 2015 was 17.6%.2 Diabetic ketoacidosis (DKA) is one of the life-threatening acute complications of diabetes mellitus (DM) that mainly occurs in type 1 diabetes patients, as well as in some patients with type 2 diabetes. It tends to present under stressful conditions or in association with illnesses that feature metabolic decompensation. DKA is characterized by hyperglycemia, ketoacidosis, and ketonuria.3 DKA affects both children and adults and requires immediate attention. The true annual incidence rate for DKA is difficult to establish, but population-based studies have reported ranges from 4.6 to 8 cases per 1,000 patients with diabetes.4,5 DKA rates may be between 5% and 7% in individuals aged <18 years.6 The global incidence of DKA is influenced by various factors and is reflective of the prevalence of diabetes in that population.7,8 Mortality due to DKA is <5% according to the American Diabetes Association (ADA).8,9 Most cases of DKA arise due to missed insulin doses, either as a result of negligence or poor socioeconomic status.10 Other precipitators of DKA include infections, cerebrovascular accidents, alcohol/drug abuse, pancreatitis, myocardial infarction, and trauma. Simple lifestyle modifications, such as educating the patients about not missing any insulin doses—especially during illness—and providing the patients with an adequate insulin reg Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

INTRODUCTION Diabetic ketoacidosis (DKA) is a very serious complication of diabetes mellitus, a metabolic disorder that is characterized by hyperglycemia, metabolic acidosis, and increased body ketone concentrations. The most common causes of DKA are infection and poor compliance with medication regimens. Other causes include undiagnosed diabetes, alcohol abuse, and a multitude of medical conditions such as cerebrovascular accident (CVA), complicated pregnancy, myocardial infarction, pancreatitis, and stress. Diabetic ketoacidosis is a complicated pathology. Early recognition of DKA, a good understanding of the pathological processes of DKA, and aggressive treatment are the keys to successful treatment. With good care, DKA can be managed and the patient will survive. OBJECTIVES When the student has finished studying this module, he/she will be able to: 1. Identify the correct definition of DKA. 2. Identify a basic function of insulin. 3. Identify the insulin derangements of types I and II diabetes. 4. Identify the basic cause of DKA. 5. Identify two specific causes of DKA. 6. Identify the two pathogenic mechanisms that produce the signs/symptoms of DKA. 7. Identify metabolic consequences of increased hormone concentrations in DKA. 8. Identify the criteria used to diagnose DKA. 9. Identify common signs and symptoms of DKA. 10. Identify laboratory abnormalities seen in DKA. 11. Identify complications of DKA. 12. Identify the three most important therapies for treating DKA. 13. Identify the correct roles of sodium bicarbonate and phosphate in treating DKA. 14. Identify an important rule for using potassium replacement in DKA. 15. Identify an important rule for switching from IV to subcutaneous insulin. EPIDEMIOLOGY Most cases of DKA are seen in patients with type I diabete Continue reading >>

Diabetic Ketoacidosis And Hyperglycaemic Hyperosmolar State

Diabetic Ketoacidosis And Hyperglycaemic Hyperosmolar State

The hallmark of diabetes is a raised plasma glucose resulting from an absolute or relative lack of insulin action. Untreated, this can lead to two distinct yet overlapping life-threatening emergencies. Near-complete lack of insulin will result in diabetic ketoacidosis, which is therefore more characteristic of type 1 diabetes, whereas partial insulin deficiency will suppress hepatic ketogenesis but not hepatic glucose output, resulting in hyperglycaemia and dehydration, and culminating in the hyperglycaemic hyperosmolar state. Hyperglycaemia is characteristic of diabetic ketoacidosis, particularly in the previously undiagnosed, but it is the acidosis and the associated electrolyte disorders that make this a life-threatening condition. Hyperglycaemia is the dominant feature of the hyperglycaemic hyperosmolar state, causing severe polyuria and fluid loss and leading to cellular dehydration. Progression from uncontrolled diabetes to a metabolic emergency may result from unrecognised diabetes, sometimes aggravated by glucose containing drinks, or metabolic stress due to infection or intercurrent illness and associated with increased levels of counter-regulatory hormones. Since diabetic ketoacidosis and the hyperglycaemic hyperosmolar state have a similar underlying pathophysiology the principles of treatment are similar (but not identical), and the conditions may be considered two extremes of a spectrum of disease, with individual patients often showing aspects of both. Pathogenesis of DKA and HHS Insulin is a powerful anabolic hormone which helps nutrients to enter the cells, where these nutrients can be used either as fuel or as building blocks for cell growth and expansion. The complementary action of insulin is to antagonise the breakdown of fuel stores. Thus, the relea Continue reading >>

Hyperglycemia: When Your Blood Glucose Level Goes Too High

Hyperglycemia: When Your Blood Glucose Level Goes Too High

Hyperglycemia means high (hyper) glucose (gly) in the blood (emia). Your body needs glucose to properly function. Your cells rely on glucose for energy. Hyperglycemia is a defining characteristic of diabetes—when the blood glucose level is too high because the body isn't properly using or doesn't make the hormone insulin. You get glucose from the foods you eat. Carbohydrates, such as fruit, milk, potatoes, bread, and rice, are the biggest source of glucose in a typical diet. Your body breaks down carbohydrates into glucose, and then transports the glucose to the cells via the bloodstream. Body Needs Insulin However, in order to use the glucose, your body needs insulin. This is a hormone produced by the pancreas. Insulin helps transport glucose into the cells, particularly the muscle cells. People with type 1 diabetes no longer make insulin to help their bodies use glucose, so they have to take insulin, which is injected under the skin. People with type 2 diabetes may have enough insulin, but their body doesn't use it well; they're insulin resistant. Some people with type 2 diabetes may not produce enough insulin. People with diabetes may become hyperglycemic if they don't keep their blood glucose level under control (by using insulin, medications, and appropriate meal planning). For example, if someone with type 1 diabetes doesn't take enough insulin before eating, the glucose their body makes from that food can build up in their blood and lead to hyperglycemia. Your endocrinologist will tell you what your target blood glucose levels are. Your levels may be different from what is usually considered as normal because of age, pregnancy, and/or other factors. Fasting hyperglycemia is defined as when you don't eat for at least eight hours. Recommended range without diabet Continue reading >>

Severe Ketoacidosis (ph ≤ 6.9) In Type 2 Diabetes: More Frequent And Less Ominous Than Previously Thought

Severe Ketoacidosis (ph ≤ 6.9) In Type 2 Diabetes: More Frequent And Less Ominous Than Previously Thought

BioMed Research International Volume 2015 (2015), Article ID 134780, 5 pages 1Division of Endocrinology, Internal Medicine Department, University Hospital “Dr. José E. González”, Autonomous University of Nuevo León, 64460 Monterrey, NL, Mexico 2Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA 3Department of Internal Medicine, University Hospital “Dr. José E. González”, Autonomous University of Nuevo León, 64460 Monterrey, NL, Mexico 4Latino Diabetes Initiative, Joslin Diabetes Center, Harvard Medical School, Boston, MA 02215, USA Academic Editor: Gianluca Bardini Copyright © 2015 René Rodríguez-Gutiérrez et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Diabetic ketoacidosis is a life-threatening acute metabolic complication of uncontrolled diabetes. Severe cases of DKA (pH ≤ 7.00, bicarbonate level ≤ 10.0, anion gap > 12, positive ketones, and altered mental status) are commonly encountered in patients with type 1 diabetes and are thought to carry an ominous prognosis. There is not enough information on the clinical course of severely acidotic type 2 diabetes (pH ≤ 6.9) patients with DKA, possibly because this condition is rarely seen in developed countries. In this series, we present 18 patients with type 2 diabetes, DKA, and a pH ≤ 6.9 that presented to a tertiary university hospital over the past 11 years. The objective was to describe their clinical characteristics, the triggering cause, and emphasis on treatment, evolution, and outcomes. The majority of Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Summarized from Nyenwe E, Kitabchi A. The evolution of diabetic ketoacidosis: An update of its etiology, pathogenesis and management. Metabolism 2016; 65: 507-21 Diabetic ketoacidosis (DKA), which is an acute, potentially life-threatening complication of poorly controlled diabetes, is the subject of a recent comprehensive review article. The authors discuss epidemiological issues, revealing increasing incidence of DKA and decreasing mortality. Once inevitably fatal, DKA now has a reported mortality rate of <1 % in adults and 5 % in the elderly who also have one or more chronic illnesses, in addition to diabetes. They reveal that although DKA more commonly affects those with type 1 diabetes, around a third of cases occur in those with type 2 diabetes. This introductory section also reminds that DKA is characterized by the presence of three cardinal biochemical features: raised blood glucose (hyperglycemia); presence of ketones in blood and urine (ketonemia, ketonuria); and metabolic acidosis. Insulin deficiency is central to the development of these three biochemical abnormalities. The very rare occurrence of euglycemic DKA (DKA with normal blood glucose) is highlighted by reference to recent reports of this condition in patients treated with a relatively new class of antidiabetic drug (the SGLT 2 inhibitors) that reduces blood glucose by inhibiting renal reabsorption of glucose. There follows discussion of factors that precipitate DKA (omission or inadequate dosing of insulin, and infection are the most common triggers), and the possible mechanisms responsible for ketosis-prone type 2 diabetes. This latter condition, which was recognized as an entity only relatively recently, is distinguished by the development of severe but transient failure of pancreatic β-cells to m Continue reading >>

Understanding The Presentation Of Diabetic Ketoacidosis

Understanding The Presentation Of Diabetic Ketoacidosis

Hypoglycemia, diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNS) must be considered while forming a differential diagnosis when assessing and managing a patient with an altered mental status. This is especially true if the patient has a history of diabetes mellitus (DM). However, be aware that the onset of DKA or HHNS may be the first sign of DM in a patient with no known history. Thus, it is imperative to obtain a blood glucose reading on any patient with an altered mental status, especially if the patient appears to be dehydrated, regardless of a positive or negative history of DM. In addition to the blood glucose reading, the history — particularly onset — and physical assessment findings will contribute to the formulation of a differential diagnosis and the appropriate emergency management of the patient. Pathophysiology of DKA The patient experiencing DKA presents significantly different from one who is hypoglycemic. This is due to the variation in the pathology of the condition. Like hypoglycemia, by understanding the basic pathophysiology of DKA, there is no need to memorize signs and symptoms in order to recognize and differentiate between hypoglycemia and DKA. Unlike hypoglycemia, where the insulin level is in excess and the blood glucose level is extremely low, DKA is associated with a relative or absolute insulin deficiency and a severely elevated blood glucose level, typically greater than 300 mg/dL. Due to the lack of insulin, tissue such as muscle, fat and the liver are unable to take up glucose. Even though the blood has an extremely elevated amount of circulating glucose, the cells are basically starving. Because the blood brain barrier does not require insulin for glucose to diffuse across, the brain cells are rece Continue reading >>

> Hyperglycemia And Diabetic Ketoacidosis

> Hyperglycemia And Diabetic Ketoacidosis

When blood glucose levels (also called blood sugar levels) are too high, it's called hyperglycemia. Glucose is a sugar that comes from foods, and is formed and stored inside the body. It's the main source of energy for the body's cells and is carried to each through the bloodstream. But even though we need glucose for energy, too much glucose in the blood can be unhealthy. Hyperglycemia is the hallmark of diabetes — it happens when the body either can't make insulin (type 1 diabetes) or can't respond to insulin properly (type 2 diabetes). The body needs insulin so glucose in the blood can enter the cells to be used for energy. In people who have developed diabetes, glucose builds up in the blood, resulting in hyperglycemia. If it's not treated, hyperglycemia can cause serious health problems. Too much sugar in the bloodstream for long periods of time can damage the vessels that supply blood to vital organs. And, too much sugar in the bloodstream can cause other types of damage to body tissues, which can increase the risk of heart disease and stroke, kidney disease, vision problems, and nerve problems in people with diabetes. These problems don't usually show up in kids or teens with diabetes who have had the disease for only a few years. However, they can happen in adulthood in some people, particularly if they haven't managed or controlled their diabetes properly. Blood sugar levels are considered high when they're above someone's target range. The diabetes health care team will let you know what your child's target blood sugar levels are, which will vary based on factors like your child's age. A major goal in controlling diabetes is to keep blood sugar levels as close to the desired range as possible. It's a three-way balancing act of: diabetes medicines (such as in Continue reading >>

Diagnosis And Management Of Type 2 Diabetes, 10th Edition, Ch 14, Pt1

Diagnosis And Management Of Type 2 Diabetes, 10th Edition, Ch 14, Pt1

Acute Complications: Metabolic – DKA Steve V. Edelman, MD Robert R. Henry, MD The most common acute complications of diabetes are metabolic problems (DKA, HHNS, hypoglycemia) and infection. In addition, the quality of life of patients with chronic and severe hypoglycemia is adversely affected. Characteristic symptoms of tiredness and lethargy can become severe and lead to increased falls in the elderly, decreased school performance in children, and decreased work performance in adults…. METABOLIC Diabetic Ketoacidosis (DKA) This acute metabolic complication typically results from a profound insulin deficiency (absolute or relative) associated with uncontrolled Type 1 diabetes mellitus and less commonly in severely decompensated Type 2 diabetes. Individuals with Type 2 diabetes may develop DKA under certain conditions: Poor nutrition that contributes to dehydration and catabolism of fat to provide necessary calories Severe physiologic stress (e.g., infection, myocardial infarction) that leads to increased levels of counterregulatory hormones (e.g., epinephrine, cortisol, and glucagon), which stimulate lipolysis, elevate free fatty acids, and stimulate hepatic ketogenesis Chronic poor metabolic control that leads to decreased insulin secretion and decreased glucose uptake (glucose toxicity) Dehydration that leads to decreased excretion of ketones in urine and a buildup of ketone bodies in the blood. Key characteristics include: Hyperglycemia (300 to 800 mg/dL although usually Ketosis: serum ketones usually 10 to 20 mM and acidosis (pH 6.8-7.3, HCO3 <15mEq/L) Dehydration caused by: Nausea Vomiting Inadequate oral intake Electrolyte depletion (e.g., potassium, magnesium, etc). Precipitating factors vary from individual to individual and may include the following (approx Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic Ketoacidosis Definition Diabetic ketoacidosis is a dangerous complication of diabetes mellitus in which the chemical balance of the body becomes far too acidic. Description Diabetic ketoacidosis (DKA) always results from a severe insulin deficiency. Insulin is the hormone secreted by the body to lower the blood sugar levels when they become too high. Diabetes mellitus is the disease resulting from the inability of the body to produce or respond properly to insulin, required by the body to convert glucose to energy. In childhood diabetes, DKA complications represent the leading cause of death, mostly due to the accumulation of abnormally large amounts of fluid in the brain (cerebral edema). DKA combines three major features: hyperglycemia, meaning excessively high blood sugar kevels; hyperketonemia, meaning an overproduction of ketones by the body; and acidosis, meaning that the blood has become too acidic. Insulin deficiency is responsible for all three conditions: the body glucose goes largely unused since most cells are unable to transport glucose into the cell without the presence of insulin; this condition makes the body use stored fat as an alternative source instead of the unavailable glucose for energy, a process that produces acidic ketones, which build up because they require insulin to be broken down. The presence of excess ketones in the bloodstream in turn causes the blood to become more acidic than the body tissues, which creates a toxic condition. Causes and symptoms DKA is most commonly seen in individuals with type I diabetes, under 19 years of age and is usually caused by the interruption of their insulin treatment or by acute infection or trauma. A small number of people with type II diabetes also experience ketoacidosis, but this is rare give Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Practice Essentials Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication of diabetes that mainly occurs in patients with type 1 diabetes, but it is not uncommon in some patients with type 2 diabetes. This condition is a complex disordered metabolic state characterized by hyperglycemia, ketoacidosis, and ketonuria. Signs and symptoms The most common early symptoms of DKA are the insidious increase in polydipsia and polyuria. The following are other signs and symptoms of DKA: Nausea and vomiting; may be associated with diffuse abdominal pain, decreased appetite, and anorexia History of failure to comply with insulin therapy or missed insulin injections due to vomiting or psychological reasons or history of mechanical failure of insulin infusion pump Altered consciousness (eg, mild disorientation, confusion); frank coma is uncommon but may occur when the condition is neglected or with severe dehydration/acidosis Signs and symptoms of DKA associated with possible intercurrent infection are as follows: See Clinical Presentation for more detail. Diagnosis On examination, general findings of DKA may include the following: Characteristic acetone (ketotic) breath odor In addition, evaluate patients for signs of possible intercurrent illnesses such as MI, UTI, pneumonia, and perinephric abscess. Search for signs of infection is mandatory in all cases. Testing Initial and repeat laboratory studies for patients with DKA include the following: Serum electrolyte levels (eg, potassium, sodium, chloride, magnesium, calcium, phosphorus) Note that high serum glucose levels may lead to dilutional hyponatremia; high triglyceride levels may lead to factitious low glucose levels; and high levels of ketone bodies may lead to factitious elevation of creatinine levels. Continue reading >>

Clinical Characteristics Of Diabetic Ketoacidosis In Children With Newly Diagnosed Type 1 Diabetes In Addis Ababa, Ethiopia: A Cross-sectional Study

Clinical Characteristics Of Diabetic Ketoacidosis In Children With Newly Diagnosed Type 1 Diabetes In Addis Ababa, Ethiopia: A Cross-sectional Study

Go to: Abstract Diabetic ketoacidosis (DKA) is one of the most serious acute complications of type 1 diabetes (T1D) and the leading cause of morbidity and mortality in children with T1D. This study was aimed at assessing the prevalence and associated factors of DKA in children with newly diagnosed T1D in Addis Ababa. A hospital based cross-sectional study was conducted in selected hospitals in Addis Ababa. Children below the age of 12 years with DKA who were admitted to the pediatric ward in the selected hospitals between January 2009 and December 2014 and the residence of Addis Ababa were included. DKA was defined as children below the age of 12 years who have blood glucose level ≥250mg/dl, ketonuria, and ketonemia and diagnosed being T1D patient for the first time. Descriptive statistics was performed using frequency distribution, mean, median, tables, and graphs. Logistic regression analysis was used to identify independent factors associated with the prevalence of DKA in children with newly diagnosed T1D. Of 395 DKA patients who were hospitalized during the five-year period, 142(35.8%) presented with DKA at first diagnosis of diabetes. On the other hand 253 (64.2%) children with DKA had longstanding T1D. Independent factors associated with DKA include: Age category 2–4.49years, 7–9.49 years and ≥9.5years (Adjusted odd ratio (AOR) = 3.14[1.21,8.06]), 3.44(1.39,8.49) and 4.02(1.68,9.60), respectively); parents’ knowledge on the sign and symptoms of DKA (AOR = 0.51[0.27, 0.95]); sign and symptoms of DKA before the onset of DKA (AOR = 0.35[0.21, 0.59]) and infection prior to DKA onset (AOR = 3.45[1.97, 6.04]). The overall proportion of children diagnosed with DKA and new onset of T1D in Addis Ababa was high. In particular, children between 9–12 years of age Continue reading >>

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