30 • Probe •Vol LXII • No. 4 • Sep–Dec 2023 Pediatrics Diabetic Ketoacidosis in Children With New-Onset Type 1 Diabetes Mellitus: Demographics, Risk Factors, and Outcomes This study aimed to analyze the incidence, clinical characteristics, management, and outcomes in children presenting with diabetic ketoacidosis (DKA) in new-onset type 1 diabetes mellitus (T1DM), from 2008 to 2018, in Hong Kong. Data were extracted from the Hong Kong Childhood Diabetes Registry. All patients aged < 18 years with newly diagnosed T1DM from January 1, 2008, to December 31, 2018, and managed in the public hospitals were included. Information on demographics, laboratory parameters, DKA-related complications, and management was analyzed. In the study period, there were 556 children with newly diagnosed T1DM in our registry, and 43.3% presented with DKA. The crude incidence rate of new-onset T1DM with DKA was 1.79 per 100,000 persons per year (CI, 1.56–2.04). Patients presenting with DKA were younger (9.5 ± 4.5 vs 10.5 ± 4.4 y, P = .01) and had a shorter duration of symptoms (4.2 ± 5.9 d vs 10.6 ± 17.1 d, P < .01). Regarding management, up to 12.4% were given insulin boluses, and 82.6% were started on insulin infusion 1 hour after fluid resuscitation. The rate of cerebral edema was 0.8%, and there was no mortality. Younger age and shorter duration of symptoms were associated with DKA in new-onset T1DM. Despite the availability of international guidelines, there was inconsistency in acute DKA management. Thus, it is required to raise public awareness on childhood diabetes as well as standardization of practice in the management of pediatric DKA in Hong Kong. Source: Poon SWY, et al. J Pediatr Endocrinol Metab. 2022;35(9):1132–1140. Nutritional Status of Children and Adolescents With Type 1 Diabetes Mellitus in Baghdad, Iraq This study evaluated the nutritional status in children and adolescents with type 1 diabetes mellitus (T1DM) in Baghdad (Iraq) and identified possible risk factors for undernutrition. A single-center, case–control study was conducted in Central Child’s Teaching Hospital, Baghdad, over 9 months, from November 2021 to July 2022. The study included patients with T1DM and healthy controls. Detailed history, clinical examination, and anthropometric measures were performed for all participants in the study. The mean age of the sample was 10.0 ± 3.73 and 8.68 ± 3.1 years in diabetic patients and controls, respectively. Anthropometric measures in patients with T1DM were significantly lower than those of controls (P < .001). All patients within the undernourished group were from large-size families compared with 75.76% of the normally nourished group, with a significant difference. The mean age of disease onset in the normal nourished group was 6.61 ± 2.78 years, which was significantly earlier than that of the undernourished group (8.83 ± 2.89 y). Weightfor-age and BMI z-score had a significant negative correlation with HbA1c (r = − 0.312, P = .004, and r = − 0.295, P = .006, respectively). Patients with T1DM had significantly lower anthropometric measures than the normal population. Older children, female gender, large family size, and disease duration are independent predictors of undernutrition in T1DM. BMI and weight-for-age have a significant negative correlation with metabolic control of diabetes represented by HbA1c. Source: Hussein SA, et al. J Med Life. 2023;16(2):254–260. Abstracts From Literature
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