A Multicenter Retrospective Survey regarding Diabetic Ketoacidosis Management in Italian Children with Type 1 Diabetes

Stefano Zucchini, Andrea E. Scaramuzza, Riccardo Bonfanti, Pietro Buono, Francesca Cardella, Vittoria Cauvin, Valentino Cherubini, Giovanni Chiari, Giuseppe D'Annunzio, Anna Paola Frongia, Dario Iafusco, Giulio Maltoni, Ippolita Patrizia Patera, Sonia Toni, Stefano Tumini, Ivana Rabbone, R. Lera, A. Bobbio, A. Gualtieri, E. PiccinnoC. Zecchino, B. Pasquino, B. Felappi, E. Prandi, F. Gallo, G. Morganti, C. Ripoli, G. Cardinale, G. Ponzi, V. Castaldo, F. Stamati, D. Lo Presti, L. Tomaselli, F. Citriniti, T. Suprani, M. Bensa, V. Graziani, F. De Berardinis, F. Chiarelli, R. De Marco, N. Lazzaro, V. De Donno, P. Banin, B. Piccini, L. Lenzi, B. Mainetti, M. S. Coccioli, N. Minuto, R. Lorini, M. Trada, P. Sogno Valin, L. Beccaria, S. Lucchesi, M. Bruzzese, F. Mammì, D. Cirillo, D. Pardi, R. A. Taccardi, F. Lombardo, G. V. Zuccotti, F. Meschi, L. Iughetti, B. Predieri, A. Franzese, E. Mozzillo, F. Prisco, F. Cadario, S. Savastio, G. Piredda, C. Monciotti, A. Galderisi, C. Salvo, V. Calcaterra, M. G. Berioli, G. Federico, A. Favia, G. Zanette, A. Marsciani, R. Schiaffini, M. Cappa, M. Delvecchio, A. Gaiero, G. Ignaccolo, F. Cerutti, F. Fontana, L. Guerraggio, S. Zonca, R. Franceschi, G. Tornese, M. Biagioni, A. Salvatoni, R. Cardani, M. Marigliano, A. Sabbion, C. Maffeis, E. Schieven, C. Arnaldi

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Abstract

We conducted a retrospective survey in pediatric centers belonging to the Italian Society for Pediatric Diabetology and Endocrinology. The following data were collected for all new-onset diabetes patients aged 0-18 years: DKA (pH <7.30), severe DKA (pH <7.1), DKA in preschool children, DKA treatment according to ISPAD protocol, type of rehydrating solution used, bicarbonates use, and amount of insulin infused. Records (n = 2453) of children with newly diagnosed diabetes were collected from 68/77 centers (87%), 39 of which are tertiary referral centers, the majority of whom (n = 1536, 89.4%) were diagnosed in the tertiary referral centers. DKA was observed in 38.5% and severe DKA in 10.3%. Considering preschool children, DKA was observed in 72%, and severe DKA in 16.7%. Cerebral edema following DKA treatment was observed in 5 (0.5%). DKA treatment according to ISPAD guidelines was adopted in 68% of the centers. In the first 2 hours, rehydration was started with normal saline in all centers, but with different amount. Bicarbonate was quite never been used. Insulin was infused starting from third hour at the rate of 0.05-0.1 U/kg/h in 72% of centers. Despite prevention campaign, DKA is still observed in Italian children at onset, with significant variability in DKA treatment, underlying the need to share guidelines among centers.

Original languageEnglish
Article number5719470
JournalJournal of Diabetes Research
Volume2016
DOIs
Publication statusPublished - 2016

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ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Zucchini, S., Scaramuzza, A. E., Bonfanti, R., Buono, P., Cardella, F., Cauvin, V., Cherubini, V., Chiari, G., D'Annunzio, G., Frongia, A. P., Iafusco, D., Maltoni, G., Patera, I. P., Toni, S., Tumini, S., Rabbone, I., Lera, R., Bobbio, A., Gualtieri, A., ... Arnaldi, C. (2016). A Multicenter Retrospective Survey regarding Diabetic Ketoacidosis Management in Italian Children with Type 1 Diabetes. Journal of Diabetes Research, 2016, [5719470]. https://doi.org/10.1155/2016/5719470