Factors associated to ketoacidosis at diagnosis of type 1 diabetes in children
Factors associated to ketoacidosis at diagnosis of type 1 diabetes in children
复制标题
DOI：
10.1016/s0929-693x(03)00033-2
复制
发表时间：
2003-04-01
影响因子：
1.8
通讯作者：
Tubiana-Rufi, N
中科院分区：
文献类型：
--
作者：
Blanc, N;Lucidarme, N;Tubiana-Rufi, N
导论. - 法国儿童I型糖尿病常在酮症酸中毒（DKA）阶段被诊断。- 对72名儿童（平均年龄= 9.4岁）在糖尿病发病时进行了一项前瞻性研究，以确定哪些因素与DKA相关以及诊断时DKA的严重程度（pH < 7.10）。- 年龄较小与DKA相关（p = 0.03），但与其严重程度无关。在有胰岛素治疗糖尿病家族史的儿童中发现DKA的发生率较低（p = 0.04）。DKA患儿的误诊率高于无DKA患儿（p = 0.02），入院时重度DKA患儿的误诊率高于非重度病例（76% vs 23%; p = 0.002）。低经济收入家庭的儿童更常表现出严重的DKA（77 vs 23%; p = 0.002），入院前更常被误诊（48% vs 10%; p < 0.01）。入院前未充分使用尿试纸进行血糖和血酮测定（仅15%）。- 这些结果强调了需要告知医生并改善低社会阶层家庭获得医疗保健的机会，以应对降低我国糖尿病儿童诊断时DKA发病率的挑战。(C)2003年，Elsevier SAS科学与医学版。吨储备。
Introduction. - Type I diabetes in children in France is frequently diagnosed at the stage of ketoacidosis (DKA).Patients and methods. - A prospective study was performed in a group of 72 children (mean age = 9.4 years) at onset of diabetes, in order to determine which factors were associated to DKA and to the severity of DKA (pH < 7.10) at diagnosis.Results. - Younger age was related to DKA (p = 0.03), but not to its severity. A lesser frequency of DKA was found in children with a family history of insulin-treated diabetes (p = 0.04). Misdiagnosis was more frequently observed in children with DKA than in children without DKA (p = 0.02) and in case of severe DKA at admission by comparison with non severe cases (76 vs 23%; p = 0.002). Children in low economic intake families exhibited more frequently a severe DKA (77 vs 23%; p = 0.002) and were more frequently misdiagnosed before admission (48% vs 10%; p < 0.01). Urine strips for glucose and ketone determinations were underused for diagnosis before admission (15% only).Conclusion. - Those results underline the need to both inform physicians and ameliorate the access to health care for low social class families, in order to take up the challenge of reducing the incidence of DKA at diagnosis in diabetic children in our country. (C) 2003 Editions scientifiques et medicales Elsevier SAS. Tons droits reserves.