Abstract:

Objective To investigate the clinical features and related influencing factors of newly diagnosed type 1 diabetes mellitus (T1DM) starting with diabetic ketoacidosis (DKA) in children, in order to improve the early identification of high-risk DKA children by clinicians and improve their survival prognosis. Methods The clinical data of 214 newly diagnosed children with T1DM admitted to the hospital from January 1, 2015 to December 31, 2021 were retrospectively analyzed. The patients were divided into DKA group and non-DKA (NDKA) group and the clinical features and laboratory examination were compared between the two groups. The multivariate logistic regression analysis was used to identify the related influencing factors of DKA occurrence in children. Results A total of 214 newly diagnosed T1DM children were included, 110 patients (51.4%) in the DKA group and 104 (48.6%) in the NDKA group. The typical clinical symptoms of diabetes such as polydipsia, polyuria, polyphagia and weight loss were more common in NDKA group, while gastrointestinal symptoms, neuropsychiatric changes and dehydration were more common in DKA group (P<0.05). The variables that were significant in univariate analysis (age, preceding infection, symptom duration, plasma C-peptide and blood glucose) were further included in multivariate logistic regression analysis, and the results showed that preceding infection (OR=7.541, 95%CI: 3.315-17.151), symptom duration (OR=0.989, 95%CI: 0.980-0.999), plasma C-peptide (OR=3.044, 95%CI: 1.571-5.899) and blood glucose (OR=5.652, 95%CI: 2.582-12.373) were independent factors influencing the occurrence of DKA in children. Conclusions Children with newly diagnosed T1DM should be cautious of developing DKA if they have a history of preceding infection, short-term symptoms, low plasma C-peptide, and high blood sugar.

Key words: type 1 diabetes mellitus, diabetes ketoacidosis, influencing factor, child