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Facteurs épidémiologiques et cliniques influençant la présence d une acidocétose lors d un diabète inaugural de type 1 chez l enfant: Revue des dix dernières années dans un centre de diabétologie pédiatrique bruxellois (HUDERF), étude transversale

par Perchec, Aurélie ;Messaaoui, Anissa ;Hajselova, Lucia;Tenoutasse, Sylvie
Référence Revue médicale de Bruxelles, 41, 3, page (150-159)
Publication Publié, 2020-02-01

Article révisé par les pairs

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Résumé :

Introduction: Diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes (T1D) is a cause of high morbidity that can be preventable If early diagnosed. The alms of this study were to characterize the prevalence of ketoacidosis at T1D diagnosis in children In the largest center for pediatric diabetology in Belgium and to highlight the risk factors and protective factors of DKA in our population. Patients and Methods: A retrospective study including all children under 18 years of age with an inaugural T1D diagnosis over 10 years, from January 1st 2009 to December 31st 2018, at the Queen Fabiola Children's University Hospital (HUDERF). Anamnestic, clinical and biological parameters were studied. Results: Among 511 children, 39.9 % had DKA criteria. The average age at diagnosis was 9.1 years (5.6-12.3y). The classic symptomatology of hyperglycemia (polyuria, polydipsia, fatigue, weight loss) was indeed found during the anamnesis, and even more frequently in case of DKA. Children presenting with DKA had more nausea/vomiting, abdominal pain and/or impaired consciousness with higher blood glucose and glycated hemoglobin levels. Conclusion: The prevalence of DKA at diagnosis of T1D in our study remained significant (nearly 40 %). The presence of a family history of T1D, a higher level of maternal education, having parents from North Africa and regular monitoring by a pediatrician were protective factors for DKA. Conversely, being a younger girl coming from the Middle East and reporting directly to the emergency department were risk factors for DKA. The early identification of clinical signs of hyperglycemia and the training of health care professionals remain a major challenge In the prevention of DKA.