Patwardhan, Radhika, Gorton, Susan, Vangaveti, Venkat N., and Yates, Jason (2018) Diabetic ketoacidosis incidence in children at first presentation of type 1 diabetes at an Australian regional hospital: the effect of health professional education. Pediatric Diabetes, 19. pp. 993-999.

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Abstract

Background: Diabetic ketoacidosis (DKA) is an acute life threatening, resource intensive pre-ventable complication of type 1 diabetes which has major biopsychosocial effects on patientsand families. Incidence of pediatric DKA has been studied nationally and internationally in met-ropolitan centers. This study analyzed the DKA incidence at first presentation of type 1 diabe-tes at Townsville Hospital, before and after an educational intervention. This is the first studyof its kind in a regional center in Queensland, Australia.

Method: The inclusion criteria consisted of children (0-18 years) diagnosed with type 1 diabetesfrom January, 2006 to December, 2016. Medical and laboratory patient data was retrospec-tively collected. Quantitative analysis was conducted using SPSS. Education sessions weredelivered to health professionals by a pediatric endocrinologist during 2015 and 2016. DKAand its severity were defined by the International Society of Pediatric Diabetes 2014Guidelines.Results: In total, 106 patients met inclusion criteria. Average incidence of DKA at first presen-tation of type 1 diabetes was 48.10%. Pre- and post-intervention incidences were 54.90% and25%, respectively (P = 0.01). DKA severity pre- and post-intervention were severe (48.88%,33.33%), moderate (26.67%, 16.67%), and mild (24.44%, 50%), respectively (P = 0.53).Conclusions: DKA incidence at first presentation of type 1 diabetes prior to intervention, ishigher than that reported by other studies in Australia: Brisbane (31.8%) and Sydney (37.7%).DKA incidence at first presentation of type 1 diabetes decreased significantly during the periodof health professional education.

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