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Research Paper | Medical Science | Albania | Volume 11 Issue 12, December 2022
Ketoacidosis as the First Presentation of Type 1 Diabetes Mellitus in Children and Adolescents during the Period 2010-2014 in Albania
Laurant Kollcaku
Abstract: Background: Diabetic ketoacidosis (DKA) is the second most common form of presentation of type 1 diabetes mellitus (T1DM) in children and adolescents and the leading cause of morbidity and mortality. The aim of this study is to assess the frequency and characteristics of DKAin children and adolescents of newly diagnosed T1DMin Albania, at the national level during the period 2010-2014. Methods: The clinical and laboratory characteristics of 152 patients <15 years old newly-onset T1DM from 1 January 2010 to 31 December 2014 were studied. T1DM was diagnosed according to WHO 2006 criteria and DKA was diagnosed based on ISPAD 2014 criteria based on values of 1) pH <7.30; 2) plasma bicarbonate concentration <15 mEq/L; 3) ketonuria> 2+. Statistical analysis was performed using SPSS 26. Results: The overall incidence of ketoacidosis was 67.8%. The mean age of children with DKA was 7.75 ? 3.64 years, while that of children without DKA was 9.29 ? 3.39 years (P = 0.012). There were no statistically significant differences by age subgroup and living residence; the percentage of females was higher in T1DMchildren with DKA (54.4%) than among those without DKA (34.7%) (p = 0.025). There is no family history of T1DM statistically significant difference between cases with and without KAD at diagnosis of T1DM. Children presented with KAD had higher mean glycemic values (p < 0.001) and triglycerides (p = 0.001) compared to children without DKA. No statistical differences were observed between in the average values of glycated hemoglobin (HbA1c) children with KAD and without KAD (p=0.195). The most common presentation symptoms of children with DKA were polyuria (100%), polydipsia (100%), and weight loss (98.1%). The frequency of malaise, vomiting, enuresisnocturna, acetone odor, dyspnea, drowsiness and confusion was higher among children with DKA (p < 0.001). Conclusion: This is the first study to report the incidence of DKA as a presentation of newly diagnosed T1DMamong Albanian children. The mean age of children with DKA was lowerand girls were found to have higher rates of ketoacidosis. The incidence is higher compared to the countries of the region. Delayed diagnosis and mismanagement are responsible for this high prevalence, the more severe presentation, especially in young children and girls. Prevention campaigns are needed to raise the awareness of healthcare providers, parents and the general public to improve early diagnosis and treatment of T1D.
Keywords: epidemiology, children, diabetes mellitus 1, diabetic ketoacidosis, Albania
Edition: Volume 11 Issue 12, December 2022,
Pages: 68 - 75