Unacceptably high rate of diabetic ketoacidosis in Ireland

The frequency of diabetic ketoacidosis (DKA) is “unacceptably high in Ireland,” according to study research presented before the IES Annual Meeting.

The researchers stated that the reduction of DKA incidence in Ireland is “an important therapeutic target”.

DKA has significant morbidity and long-term adverse impacts on metabolic control, and is a severe complication of type 1 diabetes. It impacts an estimated 12-to-80 per cent of populations, varying widely across different populations.

The objective of this study was to define and monitor the national frequency of DKA at onset of diabetes among a paediatric population over a five-year period, and to compare the results with a national study carried out in 1997/98.

The frequency of DKA in those under the age of 15 years was monitored throughout the period 2011-2015. During this period, there were 1,208 incident cases of type 1 diabetes within the outlined demographics, and of these cases, 31.6 per cent were in DKA. The Chi-square test was used to compare the groups.

The frequency of DKA remained “relatively stable over the five-year period,” as did the severity of the DKA cases. Patients with DKA presented with severe, moderate and mild cases — 11.5 per cent, 7.2 per cent and 12.9 per cent, respectively. There was no significant difference in the severity of DKA cases among different ages within the study. For individuals who did present with severe DKA, 3.6 per cent had a history of type 1 diabetes in a first-degree relative. The researchers concluded that the frequency of DKA is too high, and that it has changed very little over time. Research was carried out by the department of paediatrics at Trinity College Dublin, the department of paediatric growth, diabetes and endocrinology, Children’s Hospital Ireland at Tallaght University Hospital, the National Immunisation Office, Dublin, the University of Dublin, Trinity College Dublin, and the department of statistics, Dublin.