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[Diabetic ketoacidosis in children with newly detected type 1 diabetes in Montenegro from 1999 to 2008].

INTRODUCTION
The aim of the study was to analyze the prevalence of diabetic ketoacidosis during the period of 10 years (1999-2008) among children diagnosed with type 1 diabetes in Montenegro.


MATERIAL AND METHODS
A retrospective population-based incidence study was performed. The study participants were selected from two independent sources: the diabetes register and hospital records. The following parameters were measured before the first insulin injection: plasma glucose, blood gas analysis, electrolytes, creatinine, insulin, c-peptide, and HbA1c. Diabetic ketoacidosis was defined as pH <7.3 and severe diabetic ketoacidosis as pH <7.1. The obtained data were analysed using SPSS for Windows (version 17).


RESULTS
During the study period, 208 children <15 years of age (107 boys and 101 girls) were found to have newly diagnosed type 1 diabetes. The age- and sex-standardized incidence rate was 15.8/100,000 children/yr. Of these, 51 (24.5%) presented with diabetic ketoacidosis at the time of diagnosis and 8 (3.8%) had a severe form. and no one died. In children <5 years the prevalence was 30.4%. We found no statistically important correlation between diabetic ketoacidosis incidence, pH value and the age of children (p>0.05). There was also no significant difference in diabetic ketoacidosis incidence between the boys and girls (p>0.05).


CONCLUSION
The frequency of diabetic ketoacidosis in children with newly diagnosed type 1 diabetes in Montenegro is still high with a trend to decrease in the last ten years. In particular, children under 5 years of age are at a high risk of developing diabetic ketoacidosis at the onset.