Childhood onset type 1 diabetes at a tertiary hospital in south-western Iran during 2000–2015: Rapid increase in admissions and high prevalence of DKA at diagnosis

•The mean annual incidence of type 1 diabetes mellitus (T1DM) was raised from 18 to 27 to 138 per year during 15 years in southwest of Iran.•High prevalence of ketoacidosis and its higher mortality among girls show the warning importance of raising T1DM presented with DKA. Incidence of type 1 diabetes mellitus (T1DM) is increasing worldwide. We aimed to study trends in presentation and incidence of childhood diabetes in the last 15years in south-western Iran. During a detailed review of compiled records of the main tertiary children’s hospital of southwest of Iran, from January 2000 to December 2009, the following clinical information relevant to diabetes were analysed: admissions, demographic data, clinical and laboratory findings, hospital course, and mortality. Study continued 5years more to find out the real rate of increase. Significant findings with respect to the incidence of DKA, gender and age of subjects were summarized from among these cases. A total of 297 (known and new) cases were enrolled in the 1st (10year) stage of study and 691 new subjects in the 2nd (5year) period to check the trend in the whole 15year study period. In the 1st period; excluding 129 repeated admissions, 297 cases were enrolled for analysis: 223 new and 74 known cases. Among the new cases, 67.3% presented with DKA, without any gender bias. Mortality rate in DKA subjects was 4% with higher risk in the