Pediatria e Terapêutica

Pediatria e Terapêutica
Acesso livre

ISSN: 2161-0665


Ketoacidosis as the First Presentation of Type 1 Diabetes Mellitus in Children and Adolescents during the Period of 2010-2014 in Albania

Laurant Kollçaku*, Agim Gjikopulli, Virtut Velmishi, Sonila Tomorri, Paskal Cullufi, Ermira Dervishi

Background: Diabetic Ketoacidosis (DKA) is the second most common form of presentation of Type 1 Diabetes mellitus (T1D) in children and adolescents and the leading cause of morbidity and mortality. The purpose of this study is to assess the frequency and characteristics of DKA in children and adolescents who are newly diagnosed with T1D time in Albania, at the national level during the period 2010-2014.

Methods: The clinical and laboratory characteristics of 152 patients<15 years old newly diagnosed with T1D from 1 January 2010 to 31 December 2014 were studied. T1D was diagnosed according to WHO criteria and DKA was diagnosed based on 2014 ISPAD criteria based on values of 1) pH<7.30; 2) plasma bicarbonate concentration<15 mEq/L; 3) ketonuria>2+. Statistical analysis was performed using SPSS 26.

Results: The overall prevalence of ketoacidosis was 67.8%. The mean age of children with DKA was 7.75 ± 3.64 years, while that of children without DKA was 9.29 ± 3.39 years (P=0.012). There were no statistically significant differences by age group and place of residence, but the percentage of females was higher in T1D children with DKA (54.4%) than among those without DKA (34.7%) (P=0.025). The most common presentation symptoms of children with DKA were polyuria (100%), polydipsia (100%), and weight loss (98.1%). The prevalence of general weakness, vomiting, enuresis nocturna, acetone odor, dyspnea, drowsiness and confusion was higher among children with DKA.

Conclusion: This is the first study to report the incidence of DKA as a presentation of newly diagnosed T1D among children in Albania. The prevalence is higher compared to the countries of the region. Delayed diagnosis and mismanagement are responsible for this high prevalence, the more severe presentation, especially in young children and girls. Prevention campaigns are needed to raise the awareness of healthcare providers, parents and the general public to improve early diagnosis and treatment of T1D.