{"doi":"10.1515/jpem-2022-0255","title":"Diabetic ketoacidosis in children with new-onset type 1 diabetes mellitus: demographics, risk factors and outcome: an 11 year review in Hong Kong","abstract":"<jats:title>Abstract</jats:title>\n               <jats:sec id=\"j_jpem-2022-0255_abs_001\">\n                  <jats:title>Objectives</jats:title>\n                  <jats:p>Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes (T1D). The aim of this study is to analyze the incidence, clinical characteristics, management and outcome of children presenting with DKA in new-onset T1D from 2008 to 2018 in Hong Kong.</jats:p>\n               </jats:sec>\n               <jats:sec id=\"j_jpem-2022-0255_abs_002\">\n                  <jats:title>Methods</jats:title>\n                  <jats:p>Data was extracted from the Hong Kong Childhood Diabetes Registry. All subjects less than 18 years with newly diagnosed T1D from 1 January 2008 to 31 December 2018 managed in the public hospitals were included. Information on demographics, laboratory parameters, DKA-related complications and management were analyzed.</jats:p>\n               </jats:sec>\n               <jats:sec id=\"j_jpem-2022-0255_abs_003\">\n                  <jats:title>Results</jats:title>\n                  <jats:p>In the study period, there were 556 children with newly diagnosed T1D in our registry and 43.3% presented with DKA. The crude incidence rate of new-onset T1D with DKA was 1.79 per 100,000 persons/year (CI: 1.56–2.04). Subjects presenting with DKA were younger (9.5 ± 4.5 vs. 10.5 ± 4.4, p=0.01) and had shorter duration of symptoms (4.2 ± 5.9 days vs. 10.6 ± 17.1 days, p&lt;0.01). Regarding management, up to 12.4% were given insulin boluses and 82.6% were started on insulin infusion 1 h after fluid resuscitation. The rate of cerebral edema was 0.8% and there was no mortality.</jats:p>\n               </jats:sec>\n               <jats:sec id=\"j_jpem-2022-0255_abs_004\">\n                  <jats:title>Conclusions</jats:title>\n                  <jats:p>Younger age and shorter duration of symptoms were associated with DKA in new-onset T1D. Despite availability of international guidelines, there was inconsistency in acute DKA management. These call for a need to raise public awareness on childhood diabetes as well as standardization of practice in management of pediatric DKA in Hong Kong.</jats:p>\n               </jats:sec>","journal":"Journal of Pediatric Endocrinology and Metabolism","year":2022,"id":656959,"datarank":0.29188652235829704,"base_score":1.9459101490553132,"endowment":1.9459101490553132,"self_citation_contribution":0.29188652235829704,"citation_network_contribution":0.0,"self_endowment_contribution":0.29188652235829704,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1714862,"name":"Joanna Yuet-ling Tung","orcid":null,"position":1,"is_corresponding":false},{"id":1714863,"name":"Wilfred Hing-sang Wong","orcid":null,"position":2,"is_corresponding":false},{"id":1714864,"name":"Pik-to Cheung","orcid":null,"position":3,"is_corresponding":false},{"id":1714865,"name":"Antony Chun-cheung Fu","orcid":"0000-0002-1491-0895","position":4,"is_corresponding":false},{"id":1714866,"name":"Gloria Shir-wey Pang","orcid":null,"position":5,"is_corresponding":false},{"id":1714867,"name":"Sharon Wing-yan To","orcid":null,"position":6,"is_corresponding":false},{"id":1714868,"name":"Lap-ming Wong","orcid":null,"position":7,"is_corresponding":false},{"id":1714869,"name":"Wai-yu Wong","orcid":null,"position":8,"is_corresponding":false},{"id":1714870,"name":"Suk-yan Chan","orcid":null,"position":9,"is_corresponding":false},{"id":1714871,"name":"Ho-chung Yau","orcid":null,"position":10,"is_corresponding":false},{"id":1714872,"name":"Wing-shan See","orcid":null,"position":11,"is_corresponding":false},{"id":1714873,"name":"Betty Wai-man But","orcid":null,"position":12,"is_corresponding":false},{"id":1714874,"name":"Shirley Man-yee Wong","orcid":null,"position":13,"is_corresponding":false},{"id":1714875,"name":"Priscilla Wai-chee Lo","orcid":null,"position":14,"is_corresponding":false},{"id":1714876,"name":"Kwok-leung Ng","orcid":null,"position":15,"is_corresponding":false},{"id":1714877,"name":"Kwong-tat Chan","orcid":null,"position":16,"is_corresponding":false},{"id":1714878,"name":"Hi-yuet Lam","orcid":null,"position":17,"is_corresponding":false},{"id":1714879,"name":"Sammy Wai-chun Wong","orcid":null,"position":18,"is_corresponding":false},{"id":1714880,"name":"Yuen-yu Lam","orcid":null,"position":19,"is_corresponding":false},{"id":1714881,"name":"Hoi-wing Yuen","orcid":null,"position":20,"is_corresponding":false},{"id":1714882,"name":"Jacky Ying-ki Chung","orcid":null,"position":21,"is_corresponding":false},{"id":1714883,"name":"Ching-yee Lee","orcid":null,"position":22,"is_corresponding":false},{"id":1714884,"name":"Ming-kut Tay","orcid":null,"position":23,"is_corresponding":false},{"id":1714885,"name":"Elaine Yin-wah Kwan","orcid":null,"position":24,"is_corresponding":false},{"id":1714861,"name":"Sarah Wing-yiu Poon","orcid":"0000-0003-0818-9699","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Diabetic ketoacidosis in children with new-onset type 1 diabetes mellitus: demographics, risk factors and outcome: an 11 year review in Hong Kong","abstract":"<jats:title>Abstract</jats:title>\n               <jats:sec id=\"j_jpem-2022-0255_abs_001\">\n                  <jats:title>Objectives</jats:title>\n                  <jats:p>Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes (T1D). The aim of this study is to analyze the incidence, clinical characteristics, management and outcome of children presenting with DKA in new-onset T1D from 2008 to 2018 in Hong Kong.</jats:p>\n               </jats:sec>\n               <jats:sec id=\"j_jpem-2022-0255_abs_002\">\n                  <jats:title>Methods</jats:title>\n                  <jats:p>Data was extracted from the Hong Kong Childhood Diabetes Registry. All subjects less than 18 years with newly diagnosed T1D from 1 January 2008 to 31 December 2018 managed in the public hospitals were included. Information on demographics, laboratory parameters, DKA-related complications and management were analyzed.</jats:p>\n               </jats:sec>\n               <jats:sec id=\"j_jpem-2022-0255_abs_003\">\n                  <jats:title>Results</jats:title>\n                  <jats:p>In the study period, there were 556 children with newly diagnosed T1D in our registry and 43.3% presented with DKA. The crude incidence rate of new-onset T1D with DKA was 1.79 per 100,000 persons/year (CI: 1.56–2.04). Subjects presenting with DKA were younger (9.5 ± 4.5 vs. 10.5 ± 4.4, p=0.01) and had shorter duration of symptoms (4.2 ± 5.9 days vs. 10.6 ± 17.1 days, p&lt;0.01). Regarding management, up to 12.4% were given insulin boluses and 82.6% were started on insulin infusion 1 h after fluid resuscitation. The rate of cerebral edema was 0.8% and there was no mortality.</jats:p>\n               </jats:sec>\n               <jats:sec id=\"j_jpem-2022-0255_abs_004\">\n                  <jats:title>Conclusions</jats:title>\n                  <jats:p>Younger age and shorter duration of symptoms were associated with DKA in new-onset T1D. Despite availability of international guidelines, there was inconsistency in acute DKA management. These call for a need to raise public awareness on childhood diabetes as well as standardization of practice in management of pediatric DKA in Hong Kong.</jats:p>\n               </jats:sec>","is_dataset_classified":null,"base_score":1.791759469228055,"endowment":1.791759469228055,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"36001345","pmcid":null,"openalex_id":"https://openalex.org/W4293214191","authors":[],"funders":[],"total_grants":0,"fwci":0.7208,"citation_percentile":0.74120989,"influential_citations":0,"citation_trend":[{"year":2024,"count":1},{"year":2025,"count":3},{"year":2026,"count":1}],"oa_status":"hybrid","license":"cc-by","oa_locations":[{"url":"https://www.degruyter.com/document/doi/10.1515/jpem-2022-0255/pdf","host_type":"journal"},{"url":"https://www.degruyter.com/document/doi/10.1515/jpem-2022-0255/pdf","host_type":"publisher"},{"url":"https://www.degruyter.com/document/doi/10.1515/jpem-2022-0255/xml","host_type":"publisher"},{"url":"https://doi.org/10.1515/jpem-2022-0255","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/36001345","host_type":"repository"},{"url":"https://hub.hku.hk/handle/10722/351781","host_type":"repository"}],"fields_of_study":["Diabetes and associated disorders","Diabetes Management and Research","Pancreatic function and diabetes","Child","Diabetes Mellitus, Type 1","Diabetic Ketoacidosis","Hong Kong","Humans","Incidence","Insulin","Risk Factors"],"mesh_terms":["Child","Diabetes Mellitus, Type 1","Hong Kong","Humans","Insulin","Risk Factors","Incidence","Diabetic Ketoacidosis"],"keywords":["Medicine","Diabetic ketoacidosis","Type 1 diabetes","Pediatrics","Diabetes mellitus","Incidence (geometry)","Demographics","Complication","Insulin","Internal medicine","Endocrinology","Demography","Hong Kong","Type 1 diabetes mellitus","risk factors"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-11T23:02:47.630688Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}