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Recent trends in hospitalization for diabetic ketoacidosis in ontario children

Jacqueline R Curtis1, Teresa To, Sarah Muirhead

  • 1Department of Pediatrics, Division of Endocrinology, the Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

Diabetes Care
|August 28, 2002
PubMed

Insights

Diabetic ketoacidosis (DKA) hospitalizations in children remained stable despite reduced non-DKA admissions, indicating a need for targeted prevention strategies. Geographic variations in DKA rates persist, highlighting areas for intervention.

Area of Science:

  • Pediatric Endocrinology
  • Public Health
  • Health Services Research

Background:

  • Ambulatory care improvements have reduced non-DKA hospitalizations in children with diabetes.
  • Diabetic ketoacidosis (DKA) remains a significant concern in pediatric diabetes management.

Purpose of the Study:

  • To analyze trends and geographic disparities in pediatric diabetic ketoacidosis (DKA) hospitalization rates in Ontario between 1991 and 1999.
  • To assess the impact of healthcare interventions on DKA admissions.

Main Methods:

  • Utilized Canadian Institute for Health Information (CIHI) data for 15,872 diabetes-related hospital admissions in children under 19.
  • Conducted small area variation analysis comparing high and low DKA admission rates.
  • Analyzed trends in DKA vs. non-DKA admissions, length of stay, and fatality rates.

Main Results:

  • Overall diabetes admissions decreased by 19%; non-DKA admissions fell by 29%, while DKA admissions remained stable.
  • Average length of hospital stay decreased for both DKA and non-DKA admissions.
  • Geographic variation in DKA admissions was stable, with a 3.7-fold difference between regions.

Conclusions:

  • While non-DKA admissions have decreased due to ambulatory care, DKA rates in children with diabetes remain a concern.
  • A 3.7-fold geographic disparity in DKA admissions is clinically significant, necessitating targeted prevention.
  • Further prevention strategies are crucial, especially in regions with higher DKA hospitalization rates.
Abstract

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