Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Introduction: Diabetes Mellitus (DM) is a metabolic disorder of glucose homeostasis and is one of the most common endocrine diseases in children worldwide. Diabetic ketoacidosis (DKA) is a common serious acute complication in children with DM. Its incidence in children at the onset of DM remains high, with approximately one-third presenting with mild DKA and one-sixth with moderate or severe DKA. Multiple factors affect the risk of developing DKA at the onset of DM in children. Aim of the study: to identify and analyze the risk factors associated with the development of ketoacidosis at the diagnosis of new cases with DM. Methods: Ninety nine children (53 DKA and 46 hyperglycemia) , age range from 1 month to 13 years, diagnosed with newly diagnosed diabetes, referred and managed at DEMPU in Children{u2019}s Hospital, Cairo University. Results: Classic symptoms (polyuria, polydipsia and weight loss) were the most common symptoms (93.8% & 92%) preceding the diagnosis; and diabetic ketoacidosis was present in 53.5%. Positive family history of diabetes was recorded in 54.5%, most of them with T2DM, but with no significant difference in the presentation. Delayed and missed diagnosis was recorded in 79.8% & 53.5% respectively, with significant difference affecting the presentation. Time lapse between diagnosis and start of insulin was found to be the most significant risk factor for developing DKA at diagnosis

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