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Rates of diabetic ketoacidosis in Colorado increased to rates recorded in 80s
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ADA 70th Scientific Sessions
ORLANDO — The rates of diabetic ketoacidosis in children with type 1 diabetes living in Colorado significantly increased from 1998 to 2009, indicating major setbacks in community awareness of signs and symptoms of diabetes and access to care, Arleta Rewers, MD, said here.
The age-adjusted prevalence of children with type 1 diabetes who presented with diabetic ketoacidosis increased by more than 40% from 1998 to 2009 (29% from 1998 to 2001 vs. 41% from 2006 to 2009; P=.0014). The spike in incidence was partially explained by an increased number of patients who were uninsured and Hispanic, according to the researchers.
“This was a very surprising finding for us and it looks like it may have started as early as 2001. This is a major setback only partially explained by demographic changes,” Rewers, of the department of pediatrics, University of Colorado School of Medicine, said during a presentation.
Rewers and colleagues examined the prevalence of diabetic ketoacidosis at type 1 diabetes diagnosis in children residing in Colorado. Diagnosis was recorded between 1998 and 2001 (n=683) and between 2006 and 2009 (n=1,033). Data were pooled from the Barbara Davis Medical Center in Colorado; more than 85% of patients with type 1 diabetes in Colorado are seen that this center.
The rate of diabetic ketoacidosis from 2006 to 2009 was higher than the rate reported from 1978 to 1982 (41% vs. 38%).
“Characteristics of newly diagnosed type 1 diabetes varied by study period,” Rewers said. “The proportion of whites decreased from 88% in 1982 to 77% in 2006 and 2009. On the other hand, the proportion of Hispanic children more than doubled during the study period.”
Results of a subset analysis of 31 children who developed type 1 diabetes from 2006 to 2009 indicated that, unlike the general population, only 3% developed diabetic ketoacidosis at diagnosis. These children were identified as having a high genetic risk for type 1 diabetes and were periodically screened for development of islet autoantibodies and trained in home self blood glucose monitoring, if needed.
For more information:
- Rewers A. 299-OR. Presented at: The American Diabetes Association 70th Scientific Sessions; June 25-29, 2010; Orlando.
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