Is Diabetic Ketoacidosis A Good Predictor Of 5-Year Metabolic Control in Children with Newly Diagnosed Type 1 Diabetes?
Abstract Purpose: The study aimed to evaluate whether the presence of DKA at diabetes diagnosis was associated with poorer metabolic control during a 5-year follow-up.Methods: The study included children treated due to newly diagnosed T1D complicated with DKA between 2010-2014 with a complete 5-year follow-up. In every case we performed individual matching for age, gender and BMI with a person without DKA (nDKA) on recognition. We collected data regarding treatment modality, HbA1C, total daily insulin dose, basal insulin and BMI-SDS.Results: 85 children at the median age of 7.93 years had DKA at diabetes diagnosis. The median pH was 7.19.Continuous subcutaneous insulin infusion (CSII) was used in 87% of participants in each group. No differences in HbA1C level (7,3%vs7,2%;p=.413) were noted after 5 years of disease duration. The severity of ketoacidosis exerted no significant effect on HbA1C. The method of insulin delivery at baseline was significantly associated with HbA1C levels after 5 years of observation, βCSII=-1.46,95%CI[-2.01 to -0.92],p<.001.Conclusions: The presence of DKA at diabetes diagnosis is not associated with deteriorated long-term metabolic control in children using modern technologies. The early implementation of CSII into diabetes treatment may change the effect of DKA and lead to a long-term HbA1C improvement.