Risk Factors for Diabetic Ketoacidosis in Children with Type 1 Diabetes Mellitus: A Single-center, Cross-sectional Study in Indonesia

Abstract

Background: Diabetic ketoacidosis (DKA), the leading cause of mortality in childhood with diabetes mellitus (DM). Identification of risk factors for DKA in children with type 1 DM (T1DM), can aid in reducing the incidence of DKA.Objective: To determine risk factors for DKA in children with T1DM.Methods: This was a single-centre, cross-sectional study of patients aged 0–16 years diagnosed with T1DM who were hospitalised in or visited Dr. Soetomo General Hospital in Surabaya between January 2016 and June 2021. Data on sex, age, parental educational background, parental occupation, parental age, family history of DM and DKA frequency were collected, and statistical analyses using the SPSS software. Results: The risk of DKA was higher in children with working mothers (OR 9.3, 95%; CI 2.168–40.182, p = 0.003). Significant correlation between maternal age younger than 40 years and DKA frequency (OR 1.73, 95%; CI 8.684–3.478, p = 0.000). The highest frequency of DKA was observed in children with low parental educational level, whereas there was no correlation between age at diagnosis and parental educational level with DKA.Conclusion: Young maternal age and working mothers might be associated with increased frequency of DKA in children with T1DM.