ISSN 1662-4009 (online)

ESPE Yearbook of Paediatric Endocrinology (2018) 15 10.14 | DOI: 10.1530/ey.15.10.14

ESPEYB15 10 Type 1 Diabetes Mellitus Comorbidities – short and long-term complications (5 abstracts)

10.14 Diabetic ketoacidosis at diagnosis of T1DM predicts poor long-term glycemic control

Duca LM , Wang B , Rewers M & Rewers A


Barbara Davis Center for Diabetes, School of Medicine, University of Colorado, Aurora, CO, USA


To read the full abstract: Diabetes Care. 2017;40:1249-1255

Children and adolescents who present in ketoacidosis at manifestation of the disease might represent a subgroup of patients that may have less resilience factors in their families, less adherence to medical advice, might be less attentive to medical symptoms and might be less knowledgeable of medical issues. In addition, they may carry biologic risk factors - be it either genetic or exogenous - that lead to a more severe onset and more dramatic course of the disease. Lastly, less endogenous insulin reserve may be present in patients who enter ketoacidosis than in those who remain in a somewhat more stable metabolic condition during manifestation.

In this paper, once again the occurrence of ketoacidosis at manifestation of T1DM is linked to poor long-term glycemic control. The authors carefully excluded that this association might be confounded by sociodemographic factors. Thus, ketoacidosis at manifestation of T1DM poses a risk factor for worse metabolic control during the later course of the disease. Patients with a history of ketoacidosis at onset therefore should be closely monitored and special care should be provided to ensure better metabolic control in the long term.

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