Clinical characteristics at presentation of type 1 diabetes mellitus in children younger than 15 years in Croatia

The aim of the study was to determine the clinical and bio- chemical characteristics of type 1 diabetes mellitus (DM) at presentation in children younger than 15 years in Croatia dur- ing a 9-year period, with special attention to diabetic ketoaci- dosis (DKA) incidence. The registered data set comprised blood glucose, pH, serum bicarbonate levels, and clinical symptoms at disease manifestation. During the study period, 692 children were diagnosed with type 1 DM. Polydipsia (96.7 % ), polyuria (96.05 % ), and weight loss (82.7 % ) were the most frequent symptoms anticipating disease detection. Enuresis was recorded in 11.55 % . A total of 36.41 % patients had DKA (pH < 7.3) at disease onset. During the 9-year period, the percentage of children presenting with DKA at time of diagnosis decreased from 41.67 % to 33.33 % (z = 1.68, p = 0.046). A positive family history of DM, the only factor with an impact on the DKA incidence rate in our popula- tion, lowers the probability of the development of ketoaci- dosis. This study confi rms the importance of the detection of the classic symptoms of polyuria, polydipsia, and weight loss in patients with new-onset type 1 DM. The percentage of patients with DKA at diabetes onset decreased during the observed period but is still high and includes one-third of all patients. This is why in every acutely ill child, especially at a younger age, one should evaluate the possibility of type 1 DM to avoid the development of ketoacidosis