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首页> 外文期刊>Endocrinology, Diabetes & Metabolism >Prevalence and factors associated with diabetic ketoacidosis at diagnosis of type 1 diabetes: A report from a tertiary medical center in Central Pennsylvania
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Prevalence and factors associated with diabetic ketoacidosis at diagnosis of type 1 diabetes: A report from a tertiary medical center in Central Pennsylvania

机译：患有1型糖尿病患者糖尿病酮症病症的患病率和因素：宾夕法尼亚中部三级医疗中心的报告

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Objective To explore the rate and factors associated with diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes (T1D) in a single tertiary medical centre in Central Pennsylvania. Methods Retrospective chart review of all individuals?≤?18?years of age who were diagnosed with T1D (N?=?350) at the Penn State Hershey Pediatric Diabetes Clinic from January 2017 to December 2019. We report logistic regression models for DKA at diagnosis of T1D for age, gender, race/ethnicity, BMI percentile, health insurance, outcome of any healthcare encounter 30?days prior to T1D diagnosis, HbA 1 c level, altered mental status at diagnosis, and diagnosis of autism spectrum disorder and a multivariable logistic regression model including all aforementioned variables. Results Of the 350 newly diagnosed children with T1D from 2017 to 2019, 161/350 (46%) presented in DKA. Among patients with DKA, there were 45 (28%) in mild DKA and 116 (72%) in moderate/severe DKA, which represents 13% and 33% of all patients diagnosed with T1D, respectively. Variables associated with increased risk of DKA at presentation of T1D included age (?97%), no referral during preceding healthcare encounter, HbA 1c level and altered mental status. In a multivariable model, age (3 or 9‐13), no referral during preceding healthcare encounter, HbA 1 c level and altered mental status were associated with DKA at presentation, whereas gender, race/ethnicity, BMI percentile, health insurance and autism spectrum disorder diagnosis were not. Discussion Our study notes an overall higher rate of DKA at diagnosis (46%) compared to the SEARCH study (approximately 30%) but a lower rate compared to a recent study in Colorado children (58%).
机译：目的探讨与宾夕法尼亚州一级医疗中心1型糖尿病（T1D）诊断患者糖尿病酮症症（DKA）相关的速率和因素。方法对所有个人的回顾表审查？≤18？年龄在2017年1月至2019年1月的Penn State Hershey儿科糖尿病诊所诊断为T1D（N？=？350）。我们向DKA报告了Logistic回归模型诊断年龄，性别，种族/种族，BMI百分位，健康保险，任何医疗保险，任何医疗保健的结果30？天在T1D诊断之前，HBA 1 C水平，改变精神状态，在诊断中改变，以及诊断自闭症谱紊乱和诊断多变量逻辑回归模型，包括所有上述变量。 2017年至2019年至2019年的350名新诊断的儿童，161/350（46％）在DKA举行。在DKA患者中，温和DKA中的45（28％），中度/严重DKA的116（72％）分别代表诊断为T1D的所有患者的13％和33％。在T1D介绍时，与DKA的风险增加相关的变量包括年龄（？97％），在前面的医疗保健期间没有推荐，HBA 1C水平和改变精神状态。在多变量的模型中，年龄（＆ 3或9-13），在前后医疗保健期间没有转诊，HBA 1 C水平和改变的心理状态在演示文稿时与DKA相关联，而性别，种族/民族，BMI百分位，健康保险而自闭症谱系疾病诊断则不是。讨论我们的研究记录了与搜索研究（约30％）相比诊断（46％）的DKA的总体较高速率，但与最近在科罗拉多州儿童（58％）的研究相比，较低的速率。

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