High frequency of diabetic ketoacidosis at diagnosis of type 1 diabetes in Italian children: a nationwide longitudinal study, 2004-2013

This longitudinal population-based study analyses the frequency of diabetic ketoacidosis (DKA) at type 1 diabetes diagnosis in Italian children under 15 years of age, during 2004-2013. DKA was defined as absent (pH ≥ 7.30), mild/moderate (7.1 ≤ pH 

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Published in:Scientific reports 2016-12, Vol.6 (1), p.38844-38844, Article 38844
Main Authors: Cherubini, Valentino, Skrami, Edlira, Ferrito, Lucia, Zucchini, Stefano, Scaramuzza, Andrea, Bonfanti, Riccardo, Buono, Pietro, Cardella, Francesca, Cauvin, Vittoria, Chiari, Giovanni, D Annunzio, Giuseppe, Frongia, Anna Paola, Iafusco, Dario, Patera, Ippolita Patrizia, Toni, Sonia, Tumini, Stefano, Rabbone, Ivana, Lombardo, Fortunato, Carle, Flavia, Gesuita, Rosaria
Format: Article
Language:English
Subjects:
Adolescent
Age
Age Factors
Children
Diabetes
Diabetes mellitus
Diabetes Mellitus, Type 1 - diagnosis
Diabetes Mellitus, Type 1 - epidemiology
Diabetic ketoacidosis
Diabetic Ketoacidosis - diagnosis
Diabetic Ketoacidosis - epidemiology
Female
Humans
Italy - epidemiology
Ketoacidosis
Longitudinal Studies
Male
pH effects
Population studies
Regression analysis
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cited_by cdi_FETCH-LOGICAL-c403t-d91b8e966fed511164640e7535f904f6f7d7cecfeef51ce570aae89b2e14ac863
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creator Cherubini, Valentino
Skrami, Edlira
Ferrito, Lucia
Zucchini, Stefano
Scaramuzza, Andrea
Bonfanti, Riccardo
Buono, Pietro
Cardella, Francesca
Cauvin, Vittoria
Chiari, Giovanni
D Annunzio, Giuseppe
Frongia, Anna Paola
Iafusco, Dario
Patera, Ippolita Patrizia
Toni, Sonia
Tumini, Stefano
Rabbone, Ivana
Lombardo, Fortunato
Carle, Flavia
Gesuita, Rosaria
description This longitudinal population-based study analyses the frequency of diabetic ketoacidosis (DKA) at type 1 diabetes diagnosis in Italian children under 15 years of age, during 2004-2013. DKA was defined as absent (pH ≥ 7.30), mild/moderate (7.1 ≤ pH 
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DKA was defined as absent (pH ≥ 7.30), mild/moderate (7.1 ≤ pH &lt; 7.30) and severe (pH &lt; 7.1). Two multiple logistic regression models were used to evaluate the time trend of DKA frequency considered as present versus absent and severe versus absent, adjusted for gender, age group and geographical area of residence at diagnosis. Overall, 9,040 cases were ascertained. DKA frequency was 40.3% (95%CI: 39.3-41.4%), with 29.1% and 11.2% for mild/moderate and severe DKA, respectively. Severe DKA increased significantly during the period (OR = 1.03, 95%CI: 1.003-1.05). Younger-age children and children living in Southern Italy compared to Central Italy were at significantly higher risk of DKA and severe DKA. Family history of type 1 diabetes and residence in Sardinia compared to Central Italy were significantly associated with a lower probability of DKA and severe DKA. 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DKA was defined as absent (pH ≥ 7.30), mild/moderate (7.1 ≤ pH &lt; 7.30) and severe (pH &lt; 7.1). Two multiple logistic regression models were used to evaluate the time trend of DKA frequency considered as present versus absent and severe versus absent, adjusted for gender, age group and geographical area of residence at diagnosis. Overall, 9,040 cases were ascertained. DKA frequency was 40.3% (95%CI: 39.3-41.4%), with 29.1% and 11.2% for mild/moderate and severe DKA, respectively. Severe DKA increased significantly during the period (OR = 1.03, 95%CI: 1.003-1.05). Younger-age children and children living in Southern Italy compared to Central Italy were at significantly higher risk of DKA and severe DKA. Family history of type 1 diabetes and residence in Sardinia compared to Central Italy were significantly associated with a lower probability of DKA and severe DKA. The high frequency of ketoacidosis in Italy over time and high variability among age groups and geographical area of residence, strongly suggests a continuing need for nationwide healthcare strategies to increase awareness of early detection of diabetes.</abstract><cop>England</cop><pub>Nature Publishing Group</pub><pmid>27991500</pmid><doi>10.1038/srep38844</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record>
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subjects Adolescent
Age
Age Factors
Children
Diabetes
Diabetes mellitus
Diabetes Mellitus, Type 1 - diagnosis
Diabetes Mellitus, Type 1 - epidemiology
Diabetic ketoacidosis
Diabetic Ketoacidosis - diagnosis
Diabetic Ketoacidosis - epidemiology
Female
Humans
Italy - epidemiology
Ketoacidosis
Longitudinal Studies
Male
pH effects
Population studies
Regression analysis
title High frequency of diabetic ketoacidosis at diagnosis of type 1 diabetes in Italian children: a nationwide longitudinal study, 2004-2013
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