{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T13:47:08Z","timestamp":1785937628375,"version":"3.56.0"},"reference-count":49,"publisher":"Walter de Gruyter GmbH","issue":"9","license":[{"start":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T00:00:00Z","timestamp":1661299200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpem-2022-0255_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes (T1D). The aim of this study is\u00a0to analyze the incidence, clinical characteristics, management and outcome of children presenting with DKA in new-onset T1D from 2008 to 2018 in Hong Kong.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2022-0255_abs_002\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data was extracted from the Hong Kong Childhood Diabetes Registry. All subjects less than 18\u00a0years with newly diagnosed T1D from 1 January 2008 to\u00a031 December 2018 managed in the public hospitals were\u00a0included. Information on demographics, laboratory parameters, DKA-related complications and management were analyzed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2022-0255_abs_003\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In the study period, there were 556 children with newly diagnosed T1D in our registry and 43.3% presented with DKA. The crude incidence rate of new-onset T1D with DKA was 1.79 per 100,000 persons\/year (CI: 1.56\u20132.04). Subjects presenting with DKA were younger (9.5\u00a0\u00b1\u00a04.5 vs. 10.5\u00a0\u00b1\u00a04.4, p=0.01) and had shorter duration of symptoms (4.2\u00a0\u00b1\u00a05.9\u00a0days vs. 10.6\u00a0\u00b1\u00a017.1\u00a0days, p&lt;0.01). Regarding management, up to 12.4% were given insulin boluses and 82.6% were started on insulin infusion 1\u00a0h after fluid resuscitation. The rate of cerebral edema was 0.8% and there was no mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2022-0255_abs_004\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Younger age and shorter duration of symptoms were associated with DKA in new-onset T1D. Despite availability of international guidelines, there was inconsistency in acute DKA management. These call for a need to raise public awareness on childhood diabetes as well as standardization of practice in management of pediatric DKA in Hong Kong.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpem-2022-0255","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T13:43:34Z","timestamp":1661348614000},"page":"1132-1140","source":"Crossref","is-referenced-by-count":6,"title":["Diabetic ketoacidosis in children with new-onset type 1 diabetes mellitus: demographics, risk factors and outcome: an 11\u00a0year review in Hong Kong"],"prefix":"10.1515","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0818-9699","authenticated-orcid":false,"given":"Sarah Wing-yiu","family":"Poon","sequence":"first","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, LKS Faculty of Medicine , The University of Hong Kong , Hong Kong , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna Yuet-ling","family":"Tung","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine , Hong Kong Children\u2019s Hospital , Hong Kong , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilfred Hing-sang","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, LKS Faculty of Medicine , The University of Hong Kong , Hong Kong , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pik-to","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, LKS Faculty of Medicine , The University of Hong Kong , Hong Kong , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1491-0895","authenticated-orcid":false,"given":"Antony Chun-cheung","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine , Princess Margaret Hospital , Hong Kong , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria Shir-wey","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine , Hong Kong Children\u2019s Hospital , Hong Kong , P.R. China"},{"name":"Department of Paediatrics and Adolescent Medicine , Princess Margaret Hospital , Hong Kong , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon Wing-yan","family":"To","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine , Princess Margaret Hospital , Hong Kong , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lap-ming","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine , Tuen Mun Hospital , Hong Kong , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai-yu","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine , Tuen Mun Hospital , Hong Kong , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suk-yan","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Paediatrics , Prince of Wales Hospital , Hong Kong , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho-chung","family":"Yau","sequence":"additional","affiliation":[{"name":"Department of Paediatrics , Prince of Wales Hospital , Hong Kong , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wing-shan","family":"See","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, LKS Faculty of Medicine , The University of Hong Kong , Hong Kong , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betty Wai-man","family":"But","sequence":"additional","affiliation":[{"name":"Department of Paediatrics , Queen Elizabeth Hospital , Hong Kong , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirley Man-yee","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Paediatrics , Queen Elizabeth Hospital , Hong Kong , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscilla Wai-chee","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine , United Christian Hospital , Hong Kong , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwok-leung","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine , United Christian Hospital , Hong Kong , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwong-tat","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine , Pamela Youde Nethersole Eastern Hospital , Hong Kong , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hi-yuet","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine , Alice Ho Miu Ling Nethersole Hospital , Hong Kong , P.R. 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-yee","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine , Caritas Medical Centre , Hong Kong , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-kut","family":"Tay","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine , Tseung Kwan O Hospital , Hong Kong , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine Yin-wah","family":"Kwan","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine , Pamela Youde Nethersole Eastern Hospital , Hong Kong , P.R. 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