Abstract

To find out risk factors associated with recurrent episodes of DKA in type 1 Diabetes Mellitus in pediatric population. Methods: It was a hospital based, cross sectional, observational study, performed in a tertiary care hospital to assess the risk factors associated with recurrent DKA episodes in pediatric population (6m to 18 yrs). It was performed over a period of one year in Department of Paediatric Medicine, SMS Medical College, Jaipur. Prior permission from the institutional ethical committee was obtained. The purpose of the current study was to determine the risk factors for repeated episodes of DKA and the relationship between the severity of DKA and HbA1C in children with type 1 diabetes mellitus. Results - In our study out of the 104 study participants, maximum 59 patients (56.7%) had 2 episodes of DKA followed by 27 (26.0%) had 3 episodes of DKA, 14 (13.5%) had 4 episodes of DKA and >4 episodes were found in 4 (3.8%) Participants. In current study, mean age of the study participants who had 2 episodes of DKA was 10.98 ±4.3 years and mean age of the study participants who had >2 episodes of DKA were 12.5±3.8 years. Out of the 59 participants who had 2 episodes of DKA, maximum 22 were from age group of 10-15 years followed by 15 were from >15years and out of the 45 participants who had >2 episodes of DKA, maximum 22 were from age group of 10-15 years followed by 13 in >15 years. In our study, a statistically significant increase was found in HbA1c with number of episodes of DKA. In our study, mean HbA1c of the study participants who had 2 episodes of DKA was 9.6±2.1 gm% and mean HbA1c of the study participants who had >2episodes of DKA was 12.7±3.1 gm%. Among 104 participants, most common preceding factors responsible for recurrent DKA was poor education status [45(43.3%)], followed by infection and Lack of counseling at time of discharge in 40 (38.5%) participants each, 37 (35.6%) had deliberate omission of insulin due to lack of supply or shift to other therapy, lipodystrophy was responsible in 15(14.4%) and psychiatric factors in 12(11.5%) participants

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