What are risk factors for ketoacidosis in children with type 1 diabetes?

Researchers, in their study published in the Chinese Journal Of Contemporary Pediatrics, suggest the development of targeted intervention measures to reduce their risk of DKA.

The study was conducted by WANG Xiao-Jia, School of Public Health, Ningxia Medical University, Yinchuan, China, and colleagues to investigate the risk factors for diabetic ketoacidosis in children/adolescents with type 1 diabetes and to establish a model for predicting the risk of DKA.

For this purpose, the research team performed a retrospective analysis on 217 children/adolescents with T1DM, admitted to the General Hospital of Ningxia Medical University from 2018 to 2021. Among the 217 children/adolescents, 169 cases with DKA were included in the DKA group and 48 cases without DKA were included in the non-DKA group.

The risk factors for DKA in children/adolescents with T1DM were analyzed, and for predicting the risk of DKA in children/adolescents with T1DM, the nomogram model was established.

The study revealed the following findings:

• For the 217 children/adolescents with type 1 diabetes, the incidence rate of DKA was 77.9%.
• The multivariate logistic regression analysis showed that high levels of random blood glucose, haemoglobin A1c (HbA1c), a blood ketone body, and triglyceride on admission were closely associated with the development of DKA in the children/adolescents with T1DM (OR=1.156).
• The nomogram prediction model had a C-statistic of 0.95, with a mean absolute error of 0.004 between the risk of DKA predicted by the nomogram model and the actual risk of DKA, indicating that the model had a good overall prediction ability.

"High levels of HbA1c, triglyceride, random blood glucose, and blood ketone body on admission are closely associated with the development of DKA in children/adolescents with T1DM," the researchers wrote, adding that, 'targeted intervention measures should be developed to reduce the risk of DKA."

Reference:

Wang, Xiao-Jia, et al. "[Risk Factors for Ketoacidosis in Children/adolescents With Type 1 Diabetes Mellitus and Establishment of a Predictive Model]." Zhongguo Dang Dai Er Ke Za Zhi = Chinese Journal of Contemporary Pediatrics, vol. 26, no. 1, 2024, pp. 62-66.