Prevalence of diabetic ketoacidosis in newly diagnosed children and adolescents with type 1 diabetes mellitus. Experience of a center for pediatric diabetology in Germany

Introduction. Diabetic ketoacidosis (DKA) is still the most serious complic ation of the newly diagnosed child with diabetes mellitus type 1 because it is still the most common cause of death due to cerebral edema. Methods. All patient records of children with new diagnosed type 1 diabetes mellitus in the children's hospital of the University of Leipzig in 1995 t o 1999 were analysed retrospectively. Results. 31 patients (29,8%) had DKA, 10 of which were unconscious or somno lent. In those children and adolescents with DKA blood glucose levels, glyc osylated hemoglobin levels and initial insulin requirement were higher and the duration of hospital stay was longer. The rate of remission was lower i n the DKA group (67 vs. 80.8%). A delayed or false diagnosis was reported i n 14% of patients without but in 22,5% of the children and adolescents with DKA. Conclusion. To improve the rate of remission and reduce the hospital stay a t the onset of diabetes mellitus the rate of DKA must be reduced due to bet ter information about symptoms of diabetes mellitus in the general populati on and especially among general practitioners and pediatricians.