Research Article

Emergency Department Presentations of Diabetic Ketoacidosis in a Large Cohort of Children

Table 2

Comparison by patient age group stratified by diabetes history.

Newly diagnosed diabetesAge group (in years)p-Value
0 to less than 66 to less than 1212 to less than 18

Number of episodes184360255
Male sex187 (47.3)155 (43.1)146 (57.3)0.002
Maternal parental education1,20.39
 High school/GED or less34 (27.2)76 (27.0)47 (26.7)
 Some college/vocational school38 (30.4)82 (29.1)39 (22.2)
 College degree or more53 (42.4)124 (44.0)90 (51.1)
Household income1,20.47
 Less than $40,00041 (33.6)91 (32.9)50 (27.8)
 $40,000 to $99,99945 (36.9)102 (36.8)62 (34.4)
 $100,000 or more36 (29.5)84 (30.3)68 (37.8)
Clinical characteristics
 Headache at presentation13 (1.6)52 (14.4)40 (15.7)<0.001
 Clinically apparent cerebral injury15 (2.7)10 (2.8)0 (0.0)0.009
Laboratory results (baseline)3
 BUN (mg/dL)15 (11, 20)13 (10, 17)12 (9, 16)<0.001
 Bicarbonate (mEq/L)8 (5, 11)8 (6, 11)9 (7, 12)0.02
 Creatinine Z-score (standard units)0.2 (0.0, 0.6)0.2 (−0.1, 0.7)0.3 (0.0, 0.9)0.07
 Glucose (mg/dL)554 (468, 626)529 (435, 627)474 (380, 600)<0.001
 Potassium (mEq/L)4.7 (4.2, 5.1)4.4 (3.9, 4.9)4.2 (3.7, 4.8)<0.001
 Sodium corrected (mEq/L)139 (136, 145)140 (137, 144)140 (138, 145)0.16
 pCO2 (mm Hg)23 (18, 27)24 (20, 28)26 (22, 30)<0.001
 pH7.20 (7.09, 7.27)7.20 (7.11, 7.26)7.20 (7.12, 7.26)0.79

Previously diagnosed diabetes

Number of episodes29223628
Male sex120 (69.0)110 (49.3)263 (41.9)0.004
Maternal parental education1,20.82
 High school/GED or less6 (31.6)60 (37.3)175 (40.0)
 Some college/vocational school9 (47.4)58 (36.0)157 (35.9)
 College degree or more4 (21.1)43 (26.7)105 (24.0)
Household income1,20.47
 Less than $40,00011 (57.9)87 (52.4)244 (53.3)
 $40,000 to $99,9998 (42.1)59 (35.5)151 (33.0)
 $100,000 or more0 (0.0)20 (12.0)63 (13.8)
Clinical characteristics
 Headache at presentation14 (13.8)43 (19.3)206 (32.8)<0.001
 Clinically apparent cerebral injury12 (6.9)4 (1.8)13 (2.1)0.19
Laboratory results (baseline)3
 BUN (mg/dL)20 (15, 23)20 (17, 25)18 (14, 22)<0.001
 Bicarbonate (mEq/L)10 (7, 12)10 (7, 13)8 (6, 12)0.003
 Creatinine Z-score (standard units)0.4 (0.3, 0.6)0.7 (0.3, 1.2)0.6 (0.3, 1.2)0.30
 Glucose (mg/dL)376 (350, 527)485 (392, 600)500 (406, 600)0.004
 Potassium (mEq/L)4.9 (4.4, 5.5)5.1 (4.7, 5.7)5.1 (4.6, 5.7)0.26
 Sodium corrected (mEq/L)140 (137, 143)141 (138, 144)142 (139, 145)0.007
 pCO2 (mm Hg)25 (22, 31)29 (24, 34)27 (22, 32)0.002
 pH7.22 (7.13, 7.28)7.20 (7.13, 7.23)7.16 (7.08, 7.23)<0.001

1N (%) and p-values from Fisher’s exact tests are presented for categorical characteristics; median (25th and 75th percentile) and p-values from Wilcoxon rank sum tests are presented for all other characteristics. 2Maternal parental education and household income information were not collected for the retrospective cohort; number nonmissing and analyzed were (0–<6/6–<12/12–<18 years): (125/282/176) newly diagnosed and (19/161/437) previously diagnosed for maternal parental education, and (122/277/180) newly diagnosed and (19/166/458) previously diagnosed for household income. 3Baseline laboratory values were missing as follows (newly diagnosed 0–<6/6–<12/12–<18 years; previously diagnosed 0–<6/6–<12/12–<18 years): BUN (15/24/10; 2/17/29), bicarbonate (16/16/8; 1/8/19), creatinine (14/24/10; 3/18/31), glucose (5/8/6; 0/2/5), potassium (11/18/6; 0/8/14), sodium (10/16/10; 0/7/16), pCO2 (13/25/17; 1/10/29), pH (13/22/16; 0/11/26).