P-468: Diabetic ketoacidosis at diagnosis of type 1 diabetes in Nepalese children: prevalence and associated risk factors
S KarkiAbstract
Introduction
Although DKA can be a life-threatening event for Type 1 diabetics children, it is a preventable condition. Recent advances in diabetes management could not minimize prevalence of DKA among children with T1DM. Despite the severity of DKA, research examining the event is limited in the empirical literature. Therefore, the identification of prevalence of DKA and its associated risk factors is a pressing necessity.
Objectives
To find out the prevalence of diabetic ketoacidosis and risk factors for DKA at the diagnosis of Type 1 Diabetes Mellitus.
Methods
A hospital-based retrospective study was conducted among 211 children newly diagnosed with T1DM at Kanti Children Hospital from January 2024-March 2024. Demographic, clinical, and biochemical parameters were recorded. Patients in this study were categorized into patients presenting with DKA and patients without DKA. Associations between DKA at presentation and potential risk factors were analyzed using appropriate statistical tests.
Results
The mean age at diagnosis was 9.2 ± 4.2 years with the majority aged 5–10 years (37.9%), followed by 10–14 years (33.6%). Male-to-female (M: F) ratio was 1.49:1. DKA at diagnosis was present in 117/211 (55.5%) diabetic children. There was no statistically significant association between the occurrence of DKA and age group (p=0.794), sex (p=0.262), parental education (mother: p=0.255; father: p=0.699), season of presentation (p=0.977), family history of diabetes (p=0.663), HbA1c level (p=0.078). However, infection at presentation was significantly associated with DKA (p < 0.0001). Median C-peptide levels were significantly lower in children presenting with DKA than in those without DKA (0.30 vs 0.59 ng/mL, p = 0.022).
Conclusions
A high proportion of Nepalese children with newly diagnosed T1DM present with DKA. Although demographic and socioeconomic factors showed no significant association with the occurrence of DKA, infection and lower C-peptide levels were significantly associated with DKA at diagnosis.