INCIDENCE AND SEVERITY OF KETOACIDOSIS IN CHILDHOOD-ONSET DIABETES INKUWAIT

In 1992, the diabetes registry was started in Kuwait, as part of DiaMo nd, a WHO multinational collaborative project on the incidence of chil dhood-onset diabetes. Children (243) aged below 15 years, were identif ied between 1 January 1992 and 31 December 1995. Children (203) were K uwaiti and 40 were non-Kuwaiti children but resident of Kuwait. For th e years 1992-1993, the annual incidence of childhood onset diabetes fo r Kuwaiti children was 15.4 per 100 000 (95% confidence interval 12.9- 19), and the degree of ascertainment was 92%. Polyuria, polydypsia, we ight loss and nocturia were the most frequently reported symptoms; fou r children were in coma and one in shock at presentation. Nearly half of the children (49%) presented ketoacidosis (venous pH < 7.3 and/or p lasma bicarbonate level < 18 mmol/l) and in 53 children (23.5%) it was severe (venous pH < 7.1 and/or plasma bicarbonate level < 10 mmol/I). In 62 children (25.5%) it was mild to moderate (venous pH 7.1-7.3 and /or plasma bicarbonate level 10.1-18 mmol/l). The incidence of severe ketoacidosis was similar in all age groups and sexes, All children rec overed completely without major complications and no deaths were recor ded. We conclude that diabetic ketoacidosis is a common presentation a t the onset of diabetes in childhood in Kuwait and attests to the lack of awareness of general practitioners and parents to the symptoms and signs of diabetes in childhood. (C) 1997 Elsevier Science Ireland Ltd .