Journal of Clinical Research in Pediatric Endocrinology

[J Clin Res Pediatr Endocrinol]
J Clin Res Pediatr Endocrinol. 2024; 16(4): 411-418 | DOI: 10.4274/jcrpe.galenos.2024.2024-1-8  

Predictors and Trends of Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes Mellitus in Malaysian Children

Meenal Mavinkurve1, Nurul Hanis Ramzi2, Muhammad Yazid Jalaludin3, Nurshadia Samingan3, Azriyanti Anuar Zaini3
1IMU University, School of Medicine, Department of Paediatrics, Seremban, Malaysia
2IMU University, Institute for Research, Development and Innovation, Kuala Lumpur, Malaysia
3Universiti Malaya Faculty of Medicine, Department of Paediatrics, Kuala Lumpur, Malaysia

INTRODUCTION: Previous reports indicate that diabetic ketoacidosis (DKA) rates in Malaysian children with type 1 diabetes mellitus (T1DM) range between 54-75%, which is higher than most European nations. Knowledge of trends and predictors of DKA can be helpful to inform measures to lower the rates of DKA. However, this data is lacking in Malaysian children. Hence, the aim of this study was to determine the predictors and trends of DKA in Malaysian children at the initial diagnosis of T1DM.
METHODS: This cross-sectional study examined demographic, clinical and biochemical data of all newly diagnosed Malaysian children aged 0-18 years with T1DM over 11 years from a single centre. Regression analyses were used to determine predictors and trends.
RESULTS: The overall DKA rate was 73.2%, 54.9% of the DKA cases were severe. Age ≥5 years [odds ratio (OR): 12.29, 95% confidence interval (CI): 1.58, 95.58, p=0.017] and misdiagnosis (OR: 3.73, 95% CI: 1.36, 10.24 p=0.01) were significant predictors of a DKA presentation. No significant trends in the annual rates of DKA, severe DKA nor children <5 years presenting with DKA were found during study period.
DISCUSSION AND CONCLUSION: DKA rates at initial diagnosis of T1DM in Malaysian children are high and severe DKA accounts for a notable proportion of these. Though misdiagnosis and age ≥5 years are predictors of DKA, misdiagnosis can be reduced through better awareness and education. The lack of downward trends in DKA and severe DKA highlights the urgency to develop measures to curb its rates.

Keywords: Diabetic ketoacidosis, childhood, Malaysia, type 1 diabetes, trend


Meenal Mavinkurve, Nurul Hanis Ramzi, Muhammad Yazid Jalaludin, Nurshadia Samingan, Azriyanti Anuar Zaini. Predictors and Trends of Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes Mellitus in Malaysian Children. J Clin Res Pediatr Endocrinol. 2024; 16(4): 411-418

Sorumlu Yazar: Azriyanti Anuar Zaini, Malaysia


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