In Type 1 Diabetes, ketoacidosis not tied with poor long-term metabolic control in kids: Study

Type 1 diabetes (T1D) is one of the most common metabolic diseases in the pediatric population worldwide. The global increase in the incidence of type 1 diabetes among children still remains at the level of 3 to 5% annually.

The study aimed to evaluate whether the presence of diabetic ketoacidosis (DKA) at diabetes diagnosis was associated with poorer metabolic control during a 5-year follow-up.

The study included children treated due to newly diagnosed T1D complicated with diabetic ketoacidosis (DKA)between 2010 and 2014 with a complete 5-year follow-up. In every case we performed individual matching for age, gender and BMI with a person without diabetic ketoacidosis (DKA) (nDKA) on recognition. We collected data regarding treatment modality, HbA1C, total daily insulin dose, basal insulin and BMI-SDS.

The Results of the study are as follows:

• 85 children at the median age of 7.93 years had diabetic ketoacidosis (DKA) at diabetes diagnosis.
  
• The median pH was 7.19.
• Continuous subcutaneous insulin infusion (CSII) was used in 87% of participants in each group. No differences in HbA1C level (7,3%vs7,2%;p = .413) were noted after 5 years of disease duration.
• The severity of ketoacidosis exerted no significant effect on HbA1C.
• The method of insulin delivery at baseline was significantly associated with HbA1C levels after 5 years of observation, βCSII = − 1.46,95%CI[− 2.01 to − 0.92],p < .001.

Thus, the researchers concluded that the presence of diabetic ketoacidosis (DKA) at diabetes diagnosis is not associated with deteriorated long-term metabolic control in children using modern technologies. The early implementation of CSII into diabetes treatment may change the effect of diabetic ketoacidosis (DKA) and lead to a long-term HbA1C improvement.

Reference:

Is diabetic ketoacidosis a good predictor of 5-year metabolic control in children with newly diagnosed type 1 diabetes? By Kowalczyk Emilia et al. published in the BMC Endocrine Disorders.

https://doi.org/10.1186/s12902-021-00882-8