L. Valero-Guzmán, P. Vásquez-Hoyos, J. Camacho-Cruz, LC. Maya-Hijuelos, S. Martínez-Lozada, AM. Rubiano-Acevedo, M. Lara-Bernal, et al. (2020). Difference in the duration of pediatric diabetic ketoacidosis: Comparison of new-onset to known type 1 diabetes. Pediatric diabetes, 21(5), 791-799. https://doi.org/10.1111/pedi.13007

PubMed 32181961

[Abstract]
OBJECTIVE: To compare the duration (hours until HCO3-  ≥ 15 mmol/L) of diabetic ketoacidosis (DKA) episodes that are the first manifestation of new type 1 diabetes (NT1D) and those that are a complication in patients with previously diagnosed type 1 diabetes (PT1D).

METHODS: A multicenter retrospective cohort study was designed. The duration of DKA was measured from the start of the treatment. The primary outcome was the comparison of the time needed in each group to reach HCO3-  ≥ 15 mmol/L. The secondary outcomes were the comparison of the time to reach pH ≥ 7.3 and length of hospital stay in each group. Data were analyzed with a bivariate analysis of the variables vs primary outcome. Then, a regression model was analyzed. Results There were 305 episodes included (NT1D: 115, PT1D: 190). DKA in the NT1D group lasted longer (NT1D 20 (16-19) vs PT1D 12 (8-16), hours, P < .01) with a significant difference in each level of DKA severity. This group also took longer to reach pH ≥ 7.3 (NT1D 16 (12-22) vs PT1D 9 (6-12), hours, P < .01) and had a longer hospital stay (NT1D 9 (6-12) vs PT1D 7 (4-10), hours, P < .01).

CONCLUSION: The duration of DKA is longer in patients with NT1D regardless of characteristics like DKA severity, duration of symptoms, and type of treatments received.