05/22/2002 By Elda Hauschildt
American children with type 1 diabetes remain at high risk for diabetic ketoacidosis (DKA) and severe hypoglycaemia.
Researchers from the University of Colorado School of Medicine in Denver, report 320 hospital admissions and/or emergency room visits due to DKA during 3,994 person-years of follow-up of a cohort of 1,243 diabetic children in that city. Risk for DKA among diabetic children is eight per 100 patient years.
There were 768 episodes of hypoglycaemia in the same cohort in the 3,994 person-years of follow-up, giving risk for severe hypoglycaemia of 19 per 100 patient years. “Age- and sex-specific incidence patterns suggest that ketoacidosis is a challenge in adolescent girls while severe hypoglycaemia continues to affect disproportionally the youngest patients and boys of all ages,” say investigators.
Paediatric diabetics with psychiatric disorders, those at the extremes of the haemoglobin A(1c) (HbA1c) distribution and those who are under-insured need to be targeted for specific interventions: “Intervention programs that improve glycemic control have been shown to reduce the risk for DKA and severe hypoglycaemia and medical charges for these complications,” researchers explain. “However, there is paucity of efficiency data concerning additional medical and psychosocial support interventions to improve outcomes in children at
risk.”
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