The Analysis Study of Factor Associated with Diabetic Ketoacidosis at Onset of Type 1 Diabetes Among Pediatric Patient: A Systematic Review and Meta Analysis

Abstract

Introduction: Diabetic ketoacidosis (DKA) is a severe and potentially life-threatening complication that often occurs in children and adolescents with newly diagnosed type 1 diabetes (T1D). The factors contributing to DKA at the onset of T1D remain a significant concern in both clinical practice and public health.

Methods: This systematic review and meta-analysis examined studies that explored factors associated with the occurrence of DKA in children and adolescents at the time of T1D diagnosis. Relevant articles published between 2014 and 2024 were retrieved from databases such as PubMed, Scopus, and Google Scholar. Data were pooled using a random-effects model to assess risk factors associated with DKA development.

Results: We gathered 9 studies that represent the topic related with diabetic ketoacidosis at onset of type 1 Diabetes Mellitus in pediatric patient and conducted meta-analysis on 5 relevant findings. The analysis revealed that younger age, particularly children under 2 years, non-European ethnicity, and lower socioeconomic status were significant risk factors for DKA. A shorter duration of symptoms before diagnosis (less than five days) and higher baseline HbA1c levels were also associated with increased DKA risk. Additionally, the COVID-19 pandemic contributed to an increased incidence and severity of DKA cases, particularly among younger populations.

Discussion: The findings highlight the critical role of early recognition of diabetes symptoms and prompt access to healthcare in preventing DKA. Younger children, ethnic minorities, and those with poor access to healthcare were at higher risk, emphasizing the need for targeted public health interventions. Additionally, the ongoing pandemic has worsened access to timely medical care, further exacerbating the issue.

Conclusion: Early diagnosis, timely healthcare access, and comprehensive diabetes education are essential in reducing DKA complications. Public health strategies should focus on vulnerable populations, such as younger children and those from lower socioeconomic backgrounds, to mitigate the impact of DKA. Increased awareness and resources are crucial to improve outcomes for children with newly diagnosed T1D.