Delayed diagnosis and issues with pump usage are the leading causes of diabetic ketoacidosis in children with diabetes living in Newfoundland and Labrador, Canada
Background Newfoundland and Labrador (NL) has a very high incidence of type 1 diabetes (T1DM) and admission rate for diabetic ketoacidosis (DKA). The purpose of this study was to identify characteristics and precipitating factors associated with pediatric DKA in this population. Methods This was a r...
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ftmemorialuniv:oai:research.library.mun.ca:11828 2023-10-01T03:57:35+02:00 Delayed diagnosis and issues with pump usage are the leading causes of diabetic ketoacidosis in children with diabetes living in Newfoundland and Labrador, Canada Chafe, Roger Jackman, Jessica Albrechtsons, Daniel Porter, Robert Neil Nugent, Colleen Waheed, Shahzad Newhook, Leigh A. 2015-04-16 application/pdf https://research.library.mun.ca/11828/ https://research.library.mun.ca/11828/1/oa_chafe.pdf https://doi.org/10.1186/s13104-015-1115-y en eng BioMed Central Ltd. https://research.library.mun.ca/11828/1/oa_chafe.pdf Chafe, Roger <https://research.library.mun.ca/view/creator_az/Chafe=3ARoger=3A=3A.html> and Jackman, Jessica <https://research.library.mun.ca/view/creator_az/Jackman=3AJessica=3A=3A.html> and Albrechtsons, Daniel <https://research.library.mun.ca/view/creator_az/Albrechtsons=3ADaniel=3A=3A.html> and Porter, Robert Neil <https://research.library.mun.ca/view/creator_az/Porter=3ARobert_Neil=3A=3A.html> and Nugent, Colleen <https://research.library.mun.ca/view/creator_az/Nugent=3AColleen=3A=3A.html> and Waheed, Shahzad <https://research.library.mun.ca/view/creator_az/Waheed=3AShahzad=3A=3A.html> and Newhook, Leigh A. <https://research.library.mun.ca/view/creator_az/Newhook=3ALeigh_A=2E_=3A=3A.html> (2015) Delayed diagnosis and issues with pump usage are the leading causes of diabetic ketoacidosis in children with diabetes living in Newfoundland and Labrador, Canada. BMC Research Notes, 8 (158). ISSN 1756-0500 cc_by_nc Article PeerReviewed 2015 ftmemorialuniv https://doi.org/10.1186/s13104-015-1115-y 2023-09-03T06:48:28Z Background Newfoundland and Labrador (NL) has a very high incidence of type 1 diabetes (T1DM) and admission rate for diabetic ketoacidosis (DKA). The purpose of this study was to identify characteristics and precipitating factors associated with pediatric DKA in this population. Methods This was a retrospective study on children diagnosed with DKA from 2007–2011 admitted to the province’s only tertiary care pediatric hospital. Demographics, biochemical characteristics, and reasons for DKA diagnosis were analyzed. Chi-square and Fisher Exact tests were performed for categorical variables; t- and non-parametric Kruskal-Wallis tests were performed for continuous variables. Results A total of 90 children were admitted with DKA (39.5% newly diagnosed; 60.5% were previously diagnosed). The rate of DKA on presentation for incident cases was 22.1%. More severe cases of DKA occurred in younger, newly diagnosed patients. Almost half of preexisting diabetes cases were recurrent DKA (49.1%). The most common presenting characteristics of newly diagnosed patients were weight loss, bedwetting, polyuria, polydipsia, and neurologic symptoms. Pre-existing diabetes patients most often presented with abdominal pain and vomiting. Diagnosis of diabetes in new patients and issues related to interrupted insulin delivery in pre-existing patients using insulin pump therapy were the most common factors associated with DKA. Of the newly diagnosed patients presenting in DKA, 64% had seen a physician in the weeks leading up to diagnosis. Conclusions Pediatric patients have predictable patterns associated with a diagnosis of DKA. Most cases of DKA could be prevented with earlier diagnosis and improved education and problem-solving by families and health care providers. DKA preventative strategies are recommended and should be aimed at patients, their families, and health care professionals especially those outside of pediatric centers. Article in Journal/Newspaper Newfoundland Memorial University of Newfoundland: Research Repository Newfoundland Canada BMC Research Notes 8 1 |
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Memorial University of Newfoundland: Research Repository |
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description |
Background Newfoundland and Labrador (NL) has a very high incidence of type 1 diabetes (T1DM) and admission rate for diabetic ketoacidosis (DKA). The purpose of this study was to identify characteristics and precipitating factors associated with pediatric DKA in this population. Methods This was a retrospective study on children diagnosed with DKA from 2007–2011 admitted to the province’s only tertiary care pediatric hospital. Demographics, biochemical characteristics, and reasons for DKA diagnosis were analyzed. Chi-square and Fisher Exact tests were performed for categorical variables; t- and non-parametric Kruskal-Wallis tests were performed for continuous variables. Results A total of 90 children were admitted with DKA (39.5% newly diagnosed; 60.5% were previously diagnosed). The rate of DKA on presentation for incident cases was 22.1%. More severe cases of DKA occurred in younger, newly diagnosed patients. Almost half of preexisting diabetes cases were recurrent DKA (49.1%). The most common presenting characteristics of newly diagnosed patients were weight loss, bedwetting, polyuria, polydipsia, and neurologic symptoms. Pre-existing diabetes patients most often presented with abdominal pain and vomiting. Diagnosis of diabetes in new patients and issues related to interrupted insulin delivery in pre-existing patients using insulin pump therapy were the most common factors associated with DKA. Of the newly diagnosed patients presenting in DKA, 64% had seen a physician in the weeks leading up to diagnosis. Conclusions Pediatric patients have predictable patterns associated with a diagnosis of DKA. Most cases of DKA could be prevented with earlier diagnosis and improved education and problem-solving by families and health care providers. DKA preventative strategies are recommended and should be aimed at patients, their families, and health care professionals especially those outside of pediatric centers. |
format |
Article in Journal/Newspaper |
author |
Chafe, Roger Jackman, Jessica Albrechtsons, Daniel Porter, Robert Neil Nugent, Colleen Waheed, Shahzad Newhook, Leigh A. |
spellingShingle |
Chafe, Roger Jackman, Jessica Albrechtsons, Daniel Porter, Robert Neil Nugent, Colleen Waheed, Shahzad Newhook, Leigh A. Delayed diagnosis and issues with pump usage are the leading causes of diabetic ketoacidosis in children with diabetes living in Newfoundland and Labrador, Canada |
author_facet |
Chafe, Roger Jackman, Jessica Albrechtsons, Daniel Porter, Robert Neil Nugent, Colleen Waheed, Shahzad Newhook, Leigh A. |
author_sort |
Chafe, Roger |
title |
Delayed diagnosis and issues with pump usage are the leading causes of diabetic ketoacidosis in children with diabetes living in Newfoundland and Labrador, Canada |
title_short |
Delayed diagnosis and issues with pump usage are the leading causes of diabetic ketoacidosis in children with diabetes living in Newfoundland and Labrador, Canada |
title_full |
Delayed diagnosis and issues with pump usage are the leading causes of diabetic ketoacidosis in children with diabetes living in Newfoundland and Labrador, Canada |
title_fullStr |
Delayed diagnosis and issues with pump usage are the leading causes of diabetic ketoacidosis in children with diabetes living in Newfoundland and Labrador, Canada |
title_full_unstemmed |
Delayed diagnosis and issues with pump usage are the leading causes of diabetic ketoacidosis in children with diabetes living in Newfoundland and Labrador, Canada |
title_sort |
delayed diagnosis and issues with pump usage are the leading causes of diabetic ketoacidosis in children with diabetes living in newfoundland and labrador, canada |
publisher |
BioMed Central Ltd. |
publishDate |
2015 |
url |
https://research.library.mun.ca/11828/ https://research.library.mun.ca/11828/1/oa_chafe.pdf https://doi.org/10.1186/s13104-015-1115-y |
geographic |
Newfoundland Canada |
geographic_facet |
Newfoundland Canada |
genre |
Newfoundland |
genre_facet |
Newfoundland |
op_relation |
https://research.library.mun.ca/11828/1/oa_chafe.pdf Chafe, Roger <https://research.library.mun.ca/view/creator_az/Chafe=3ARoger=3A=3A.html> and Jackman, Jessica <https://research.library.mun.ca/view/creator_az/Jackman=3AJessica=3A=3A.html> and Albrechtsons, Daniel <https://research.library.mun.ca/view/creator_az/Albrechtsons=3ADaniel=3A=3A.html> and Porter, Robert Neil <https://research.library.mun.ca/view/creator_az/Porter=3ARobert_Neil=3A=3A.html> and Nugent, Colleen <https://research.library.mun.ca/view/creator_az/Nugent=3AColleen=3A=3A.html> and Waheed, Shahzad <https://research.library.mun.ca/view/creator_az/Waheed=3AShahzad=3A=3A.html> and Newhook, Leigh A. <https://research.library.mun.ca/view/creator_az/Newhook=3ALeigh_A=2E_=3A=3A.html> (2015) Delayed diagnosis and issues with pump usage are the leading causes of diabetic ketoacidosis in children with diabetes living in Newfoundland and Labrador, Canada. BMC Research Notes, 8 (158). ISSN 1756-0500 |
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cc_by_nc |
op_doi |
https://doi.org/10.1186/s13104-015-1115-y |
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BMC Research Notes |
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8 |
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