Endocrine Abstracts

Objectives: The objective of this single-centre study at the University Hospitals Bristol and Weston (UHBW) is to ascertain the incidence of diabetic ketoacidosis (DKA) in children with new-onset type 1diabetes and known patients with type 1 diabetes (T1D), and to explore the reasons for DKA among these groups during the period of October 2022-October2023

Methodology: The characteristics of patients who presented with DKA between October 2022 and October 2023 were documented. Data was collected retrospectively from the medical records of these patients.

Results: • Total Episodes of DKA: 42 DKA episodes from October 2022 to October 2023.

• Newly Diagnosed vs. Known T1D: 54% were newly diagnosed, and 46% were known T1D patients.

• Gender Distribution: 52% females, 48% males.

• Ethnicity: 80% of the patients were from a white ethnic background.

• Age Range: 2-17 years, with a mean age of 12 years.

• IMD Score: 20% of the known patients have an IMD score of 3 or lower, while 64% of the population has an IMD score of 5 or lower.

• Insulin Management in Known T1D Patients:

o 90% were on multiple daily injections (MDI).

o 10% were on an insulin pump.

• Reasons for DKA in Known T1D Patients:

o 64% due to insulin omission.

o 26% due to inter-current illness.

• Management and Education Gaps in Known T1D Patients:

o None had contacted the Paediatric Diabetes Specialist Nurse (PDSN) 48 hours prior to admission.

o None had followed sick day rules.

o Only 5% had checked ketones in the 48 hours prior to admission.

• Reasons for DKA in New Onset T1D Patients:

o 43% due to lack of awareness of diabetes symptoms among families.

Conclusion: The findings indicate a critical need for close follow-up and enhanced education and support for patients with type 1 diabetes, especially those from lower socioeconomic backgrounds as identified by IMD scoring. Furthermore, there is a significant need for improved public education about the symptoms of diabetes to reduce the incidence of DKA at the time of diagnosis.