KETOACIDOSIS AT THE DIAGNOSIS OF TYPE-1 (INSULIN-DEPENDENT) DIABETES-MELLITUS IS RELATED TO POOR RESIDUAL BETA-CELL FUNCTION

The determinants of the degree of metabolic decompensation at the diag nosis of type 1 (insulin dependent) diabetes mellitus (IDDM) and the p ossible role of diabetic ketoacidosis in the preservation and recovery of residual beta cell function were examined in 745 Finnish children and adolescents. Children younger than 2 years or older than 10 years of age were found to be more susceptible to diabetic ketoacidosis than children between 2 and 10 years of age (< 2 years: 53.3%; 2-10 years: 16.9%; > 10 years: 33.3%). Children from families with poor parental educational level had ketoacidosis more often than those from families with high parental educational level (24.4% v 16.9%). A serum C pepti de concentration of 0.10 nmol/l or more was associated with a favourab le metabolic situation. Low serum C peptide concentrations, high requi rement of exogenous insulin, low prevalence of remission, and high gly cated haemoglobin concentrations were observed during the follow up in the group of probands having diabetic ketoacidosis at the diagnosis o f IDDM. Thus diabetic ketoacidosis at diagnosis is related to a decrea sed capacity for beta cell recovery after the clinical manifestation o f IDDM in children.