{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T11:54:57Z","timestamp":1764330897337},"reference-count":19,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,2,12]],"date-time":"2016-02-12T00:00:00Z","timestamp":1455235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To assess the management of diabetic ketoacidosis in young people, which differs in the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> between paediatric and adult services, and to evaluate outcomes and extent to which national guidelines are used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A standardized questionnaire was sent to all paediatric and adult diabetes services in England, requesting details of all diabetic ketoacidosis admissions in young people aged &gt; 14 years in paediatric services (\u2018paediatric\u2019 patients), and in young adults up to the age of 22 years in adult services (\u2018adult\u2019 patients).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 64 adult patients aged \u2264 22 years (mean age 19.2 years) were reported, of whom seven were aged between 10 and 16 years. A total of 71 paediatric patients were reported [mean (range) age 14.9 (11\u201318) years]. We found that 85% of paediatric and 69% of adult patients were treated according to national guidelines, 99% of paediatric and 89% of adult patients were treated with 0.9% saline and fixed\u2010rate insulin infusions and 16% of adult patients received an insulin bolus. Insulin treatment was initiated later in paediatric patients than in adult patients (100 vs 39 min; <jats:italic>P<\/jats:italic> &lt; 0.001). In 23% of adult patients and 8.8% of paediatric patients, potassium levels were &lt; 3.5 mmol\/l (<jats:italic>P<\/jats:italic> &lt; 0.005). The lowest mean potassium levels were 3.8 mmol\/l in paediatric and 3.5 mmol\/l in adult patients (<jats:italic>P<\/jats:italic> &lt; 0.005). Hypoglycaemia occurred in 42.3% of paediatric and 36% of adult patients. Time to resolution was similar in paediatric and adult patients (16.0 vs 18.2 h), as was duration of hospital stay (2.35 vs 2.53 days).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Young people were treated according to national guidelines, but the quality of monitoring was variable in both paediatric and adult settings. The incidence of hypoglycaemia and hypokalaemia was unacceptably high.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.13065","type":"journal-article","created":{"date-parts":[[2016,1,16]],"date-time":"2016-01-16T18:16:13Z","timestamp":1452968173000},"page":"1352-1359","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Diabetic ketoacidosis in an adolescent and young adult population in the <scp>UK<\/scp> in 2014: a national survey comparison of management in paediatric and adult settings"],"prefix":"10.1111","volume":"33","author":[{"given":"J. A.","family":"Edge","sequence":"first","affiliation":[{"name":"Oxford Children's Hospital Headington Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I.","family":"Nunney","sequence":"additional","affiliation":[{"name":"Norwich Medical School University of East Anglia Norwich UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. K.","family":"Dhatariya","sequence":"additional","affiliation":[{"name":"Elsie Bertram Diabetes Centre Norfolk and Norwich University Hospitals NHS Foundation Trust Norwich UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,2,12]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Health and Social Care Information Centre.National Diabetes Inpatient Audit (NaDIA) Open data \u2010 2013. Available athttp:\/\/www.hscic.gov.uk\/catalogue\/PUB14358Last accessed 16 July 2015."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a113577"},{"key":"e_1_2_9_4_1","unstructured":"British Society of Paediatric Endocrinology and Diabetes.Guidelines for the management of diabetic ketoacidosis 2009 (minor review 2013). Available athttp:\/\/www.bsped.org.uk\/clinical\/docs\/DKAGuideline.pdfLast accessed 16 July 2015."},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.81.4.318"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200101253440404"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.7.1541"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-006-0363-8"},{"key":"e_1_2_9_9_1","unstructured":"SavageMW Sinclair\u2010HammersleyM RaymanG CourtneyH DhatariyaK DyerPet al.The management of diabetic ketoacidosis in adults. Available athttp:\/\/www.diabetologists-abcd.org.uk\/JBDS\/JBDS_IP_DKA_Adults.pdfLast accessed 16 July 2015."},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2011.03246.x"},{"key":"e_1_2_9_11_1","volume-title":"The management of diabetic ketoacidosis in adults","author":"Dhatariya K","year":"2013"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.15277\/bjdvd.2014.042"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12875"},{"key":"e_1_2_9_14_1","unstructured":"Royal College of Paediatrics and Child Health.National Paediatric Diabetes Audit 2013\u201014. Part 1. Care processes and outcomes. Available athttp:\/\/www.rcpch.ac.uk\/system\/files\/protected\/page\/2014%20NPDA%20Report%201%202014%20FINAL.pdfLast accessed 16 July 2015."},{"key":"e_1_2_9_15_1","unstructured":"Virtual College.The safe use of insulin 2014 update \u2010 e learning module. 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Available athttps:\/\/www.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/214902\/PbR-Guidance-2013-14.pdfLast accessed 16 July 2015."}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdme.13065","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.13065","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T20:16:34Z","timestamp":1694895394000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.13065"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,2,12]]},"references-count":19,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2016,10]]}},"alternative-id":["10.1111\/dme.13065"],"URL":"https:\/\/doi.org\/10.1111\/dme.13065","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,2,12]]},"assertion":[{"value":"2016-01-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-02-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}