To the Editor: The incidence of type 1 diabetes (T1D) in children is rising globally, including in Australia.1 Diabetic ketoacidosis (DKA) is the leading cause of diabetes-related deaths in children.2 Clinical manifestations of DKA include dehydration; rapid, deep, sighing (Kussmaul respiration); nausea; vomiting; abdominal pain and a reduced level of consciousness.2 There is an inverse relationship between the frequency of presentation with DKA and background incidence of T1D in a given country,3 suggesting that the diagnosis is more likely to be considered earlier in countries with higher incidence of T1D, such as Australia.
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- 1. Catanzariti L, Faulks K, Moon L, et al. Australia’s national trends in the incidence of Type 1 diabetes in 0–14-year-olds, 2000–2006. Diabet Med 2009; 26: 596–601.
- 2. Wolfsdorf J, Craig ME, Daneman D, et al. Diabetic ketoacidosis in children and adolescents with diabetes. Pediatr Diabetes 2009; 10 Suppl 12: 118-133.
- 3. Usher-Smith JA, Thompson MJ, Sharp SJ, Walter FM. Factors associated with the presence of diabetic ketoacidosis at diagnosis of diabetes in children and young adults: a systematic review. BMJ 2011; 343: d4092.
- 4. Abdul-Rasoul M, Al-Mahdi M, Al-Qattan H, et al. Ketoacidosis at presentation of type 1 diabetes in children in Kuwait: frequency and clinical characteristics. Pediatr Diabetes 2010; 11: 351-356.
- 5. Craig ME, Twigg SM, Donaghue KC, et al. National evidence-based clinical care guidelines for type 1 diabetes in children, adolescents and adults. Canberra: Department of Health and Ageing, 2011. http://www.nhmrc.gov.au/guidelines/ publications/ext004 (accessed Jul 2012).
No relevant disclosures.