The Frequency of Ketoacidosis and Associated Factors at the Diagnosis of Type 1 Diabetes in Turkish Children: A Single-center Experience and Literature Review

Aim: We aimed to investigate the frequency of diabetic ketoacidosis (DKA) and the associated factors at the time of diagnosis of type 1 diabetes (T1D) in children in a tertiary health center in Turkey, and to review previous studies conducted in Turkey. Materials and Methods: Data of 180 children with T1D (98 boys) aged 1 to 18 years were analyzed retrospectively. All children were consecutively diagnosed as having T1D at our pediatric endocrinology clinic between April 2016 and December 2019. To conduct a literature review, we screened PubMed, Google Scholar, Web of Science, and article reference lists as well as the proceedings of the national conferences organized by the Turkish Pediatric Endocrinology and Diabetes Society for the period until January 1st, 2020. Results: DKA was detected in 81 (45.0%) children with T1D at the time of diagnosis in this cohort. An association between DKA and high glycated hemoglobin (HbA1c) levels at the time of diagnosis was determined (p=0.038). Furthermore, a relationship was also detected between severe DKA (pH