Aims

In this study we described the clinical and laboratory features of children presented with diabetic ketosis or diabetic ketoacidosis at diagnosis of type 1 diabetes (T1DM) and evaluated its course up to 2 years after initial diagnosis to investigate the progression rate of T1DM in both groups.

Methods

This was a prospective longitudinal cohort study that included 59 children and adolescents presented with either diabetic ketosis (DK) (n = 27) or diabetic ketoacidosis (DKA) (n = 32) at their first diagnosis with T1DM.

Results

Apart from the metabolic state of presentation at diagnosis, differences in the other basic clinical and laboratory features of both DK and DKA were not statistically significant (age, BMI, pre- diagnosis symptomatic period, HbA1c, multiplicity of autoantibodies positivity, fasting insulin, and total IgG levels), except from the C-peptide and IgA levels which were lower in DKA (p < 0.05). Regarding family history, only the DK group had individuals with a parent diagnosed with T1DM (p = 0.001). During follow-up there was no difference in the levels of HbA1c, basal insulin dose, and insulin/carbohydrate ratio between the DK and DKA group at 3,6,12 and 24 months' time points.

Conclusions

The severity of presentation of T1DM (DK or DKA) is not associated to the rate of progression of the disease course after diagnosis.

中文翻译：

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糖尿病酮症与酮症酸中毒作为小儿 1 型糖尿病的初始表现。诊断后头两年内的相关特征和进展率

目标

在这项研究中，我们描述了诊断为1 型糖尿病 (T1DM) 时出现糖尿病酮症或糖尿病酮症酸中毒的儿童的临床和实验室特征，并评估了初次诊断后长达 2 年的病程，以调查两组中 T1DM 的进展率。

方法

 这是一项前瞻性纵向队列研究，纳入了 59 名首次诊断为 T1DM 时患有糖尿病酮症 (DK) ( n  = 27) 或糖尿病酮症酸中毒 (DKA) ( n = 32) 的儿童和青少年。

结果

除了诊断时表现出的代谢状态外，DK 和 DKA 的其他基本临床和实验室特征差异无统计学意义（年龄、BMI、诊断前症状期、HbA1c、自身抗体阳性复数、空腹胰岛素和血糖水平）。总 IgG 水平），但 DKA 中 C 肽和 IgA 水平较低（p  < 0.05）。关于家族史，只有 DK 组有父母被诊断患有 T1DM 的个体 ( p  = 0.001)。随访期间，DK 组和 DKA 组在 3、6、12 和 24 个月时间点的 HbA1c 水平、基础胰岛素剂量和胰岛素/碳水化合物比率没有差异。

结论

T1DM（DK 或 DKA）的严重程度与诊断后病程的进展速度无关。