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Delayed referral of new-onset type 1 diabetes increases the risk of diabetic ketoacidosis

Maria E Craig, Catherine H Wong, Joanna Alexander, Ann M Maguire and Martin Silink
Med J Aust 2009; 190 (4): . || doi: 10.5694/j.1326-5377.2009.tb02356.x
Published online: 16 February 2009

To the Editor: The incidence of type 1 diabetes mellitus (T1DM) is increasing in Australia.1,2 There is also general consensus that the incidence of diabetic ketoacidosis (DKA) is increasing in children, as noted in an Australian study.3 We conducted a retrospective audit of the referral pattern of patients with newly diagnosed T1DM presenting to the Children’s Hospital at Westmead, a tertiary referral centre serving the population of western Sydney.


  • Institute of Endocrinology and Diabetes, The Children’s Hospital at Westmead, Sydney, NSW.


Correspondence: m.craig@unsw.edu.au

  • 1. Chong JW, Craig ME, Cameron FJ, et al. Marked increase in type 1 diabetes mellitus incidence in children aged 0-14 yr in Victoria, Australia, from 1999 to 2002. Pediatr Diabetes 2007; 8: 67-73.
  • 2. Taplin CE, Craig ME, Lloyd M, et al. The rising incidence of childhood type 1 diabetes in New South Wales, 1990–2002. Med J Aust 2005; 183: 243-246. <eMJA full text> <MJA full text>
  • 3. Bui TP, Werther GA, Cameron FJ. Trends in diabetic ketoacidosis in childhood and adolescence: a 15-yr experience. Pediatr Diabetes 2002; 3: 82-88.
  • 4. Australasian Paediatric Endocrine Group. Clinical practice guidelines: type 1 diabetes in children and adolescents. Canberra: Australian Government Department of Health and Ageing, 2005.
  • 5. Vanelli M, Chiari G, Ghizzoni L, et al. Effectiveness of a prevention program for diabetic ketoacidosis in children. An 8-year study in schools and private practices. Diabetes Care 1999; 22: 7-9.

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