The investigation of patients with diabetic ketoacidosis in Çukurova University Faculty of Medicine Pediatric Endocrinology Department in the last 10 years

ABSTRACT The Investigation of Patients with Diabetic Ketoacidosis in Çukurova University Faculty of Medicine Pediatric Endocrinology Department in the Last 10 Years Objectives: Type 1 Diabetes Mellitus (DM) is a disease characterized by pancreatic β cell destruction leading to partial or absolute insulin deficiency. Diabetic Ketoacidosis (DKA) is a major complication of type 1 DM and also rarely type 2 DM and can be life-threatening due to severe metabolic acidosis, dehydration and electrolyte abnormalities. In this study, it was aimed to determine the demographic, clinical and laboratory characteristics of tip 1 DM presenting with diabetic ketoacidosis in the last 10 years. Materials and Methods: This is a retrospective study conducted between 2009 to 2019 at Cukurova University Faculty of Medicine, Balcalı Hospital, Department of Pediatric Endocrinology in patients with DKA aged 1 to 18 years. Totally, 226 patients were included in the study. Results: 104 (46%) patients were female, 122 (54%) were males. While 192 (85%) of the patients were newly diagnosed type 1 DM (NT1D), 34 (15%) patients were previously diagnosed Type 1 DM (PT1D). The mean age of the all patients was 9.4±4.1 years. The most common symptoms at admission were polyuria (85.9%), polydipsia (85.4%) and weight loss (38.5%) in NT1D, vomiting (55.9%), abdominal pain (35.3%) and fatigue (26.5%) in PT1D. ICA autoantibody (ab) was positive in 31.6% and Anti-GAD ab was positive in 38.5% of the patients. Height SDS was -0.1±1.1 and -0.7±1.1, in N1TD and PT1D, respectively (p=0.005). 47.8% of the patients were classified as mild, 27.9% moderate and 24.3% severe DKA. The mean diabetes symptom duration was 19.5 ± 23.3 days, 5.4 ± 6.4 days, in NT1D and PT1D, respectively (p=0.000). While the mean HbA1c value of all patients was 12.6% ± 2.3, 12.7% ± 2.4 for mild DKA, 12.3% ± 2.3 for moderate DKA and 12.7% ± 1.9 for severe DKA (p = 0.499). It was observed that the higher DKA level was related to the lower the C peptide value (p=0.000). The severity of DKA was found to be correlated with impairment of consciousness level (p=0.000). Conclusion: The mean age at admission was 9.4 ± 4.1 years. The most common symptoms were polyuria (85.9%), polydipsia (85.4%) and weight loss (38.5%) in NT1D, vomiting (55.9%), abdominal pain (35.3%) and fatigue (26.5%) in PT1D. DKA severity levels were 47.8% mild, 27.9% moderate and 24.3% severe. It was found that higher degree of DKA was associated with increased length of hospital stay and brain edema. The duration of diabetes symptoms and hospital stay were longer in NT1D than PT1D. Keywords: Diabetic Ketoacidosis, Type 1 Diabetes Mellitus, Children