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Patients with DKA of different severities may have different clinical manifestations, serum biochemical levels and hormone changes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively evaluated the clinical manifestations, serum hormone levels, and biochemical levels of 70 Chinese patients with moderate to severe type 1 DKA in the acute and recovery phases admitted to Shanghai Children\u2019s Hospital from 2015 to 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The time required for acidosis correction in 37 patients with severe DKA was 5.9\u00a0h longer than that in 33 patients with moderate DKA (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). In addition, serum levels of serum ionized calcium (<jats:italic>P<\/jats:italic>\u2009=\u20090.003), free triiodothyronine (FT3) (<jats:italic>P<\/jats:italic>\u2009=\u20090.029), white blood cells (WBCs) (<jats:italic>P<\/jats:italic>\u2009=\u20090.044), and triglycerides (TGs) (<jats:italic>P<\/jats:italic>\u2009=\u20090.002) were significantly different between patients with moderate and severe DKA. Serum levels of ionized calcium decreased significantly after recovery from severe DKA. Within 1 week, thyroid hormone and blood lipid levels recovered to normal ranges without intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with severe DKA had higher acidosis correction times, higher WBC counts, TGs and ionized calcium levels, and lower FT3 levels than patients with moderate DKA. No additional intervention was required for thyroid hormone, and blood lipid and serum ionized calcium levels recovered to the normal range.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12902-022-01227-9","type":"journal-article","created":{"date-parts":[[2022,12,2]],"date-time":"2022-12-02T11:53:59Z","timestamp":1669982039000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical, hormonal, and biochemical characteristics of 70 chinese children with moderate to severe type 1 diabetic ketoacidosis"],"prefix":"10.1186","volume":"22","author":[{"given":"Qingxu","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqin","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,12,2]]},"reference":[{"issue":"7","key":"1227_CR1","doi-asserted-by":"publisher","first-page":"544","DOI":"10.3109\/09537104.2012.735720","volume":"24","author":"S Ma","year":"2013","unstructured":"Ma S, Yang L, Qiu X. 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The study was approved by the ethics committee of Shanghai Children\u2019s Hospital Affiliated with Shanghai Jiao Tong University (2020R132-E01, Shanghai, China). The patients consented to participate in this study. Informed consent was obtained from all subjects and their legal guardians.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.\u00a0","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declare that they have no conflicts of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"301"}}