Analysis Of Clinical Characteristics In 140 Children And Adolescents With Hospitalized Diabetes Mellitus

Objectives:1)To analyze the epidemiological features of the children with diabetes hospitalized in a single center.2)To analyze the clinical characteristics of children with diabetic ketoacidosis?DKA?and the influencing factors of DKA,and further explore the risk factors of DKA.3)To analyze the influencing factors and prognosis of the different severity of DKA.Methods:1)A total of 140 children with diabetes mellitus admitted to the Department of Pediatrics,Tianjin Medical University General Hospital from 2009.1.1—2018.12.31were collected.The number of children with diabetes each year and the proportion of diabetes mellitus were counted.Summarize the differences of gender,current residence,family history of diabetes,average hospital stay,hospitalization costs,age at onset,and inducement between the children with Type l diabetes mellitus?T1DM?and Type 2 diabetes mellitus?T2DM?.2)140 children were divided into DKA group and non-DKA group according to the different forms of onset.The clinical characteristics of the two groups including general condition,clinical manifestation,admission blood gas analysis and laboratory examination were summarized.3)50 children in the DKA group were divided into mild group,moderate group and severe group according to the severity of the disease.Analyzed the clinical characteristics and prognosis of the three groups.Results:1)Children with diabetes are mainly T1DM,and the overall incidence is increasing year by year.2)Compared with the non-DKA group,the DKA group had a longer average hospitalization period and higher hospitalization costs;it was more prone to polydipsia,polyuria,weight loss,and fever,fatigue,and chest tightness?P<0.05?.There were significant differences in blood gas analysis,thyroid function,blood lipids,myocardial enzymes and creatinine levels between the two groups?P<0.05?.Logistic regression analysis showed that glycosylated hemoglobin?HbA1c?,and white blood cell count were independent risk factors for DKA,while C-peptide,low T3syndrome,hypertriglyceridemia and nervous system manifestations were independent protective factor of DKA.3)Compared to mild and moderate DKA,severe DKA is more prone to chest tightness and has higher levels of blood osmotic pressure,urea and creatinine.Logistic regression analysis showed that blood osmotic pressure,creatinine and chest tightness were independent factors influencing the severity of DKA.There was a significant difference in the correction time of DKA?mild vs.moderate vs.severe=9.0h vs.15.25h vs.24.5 h,P<0.001?.The children with severe DKA,are more likely to have neurological symptoms pejorative,and it is necessary to be alert to brain edema?CE?.Conclusions:1)The number of children with diabetes in hospitalized children and adolescents is gradually increasing,with T1DM accounting for the majority and T2DM for the second.2)Children with DKA have a longer average hospital stay and a higher average hospitalization cost.Children with DKA have lower C-peptide levels,HbA1c,blood osmotic pressure,white blood cell count,and creatinine levels,with more neurological symptoms,low T3 syndrome,and greater dyslipidemia.3)In addition to the blood PH and blood HCO₃^-referenced in evaluating the severity of the condition,patients with severity DKA are more prone to higher blood osmotic pressure,higher creatinine level and chest tightness.The heavier the conditon,the longer the DKA takes to correct.In the course of treatment,neurological symptoms may pejorative in moderate and severe DKA.It is necessary to be alert to CE.