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ORIGINAL ARTICLE • Cogitare Enferm. 27 • 2022 • https://doi.org/10.5380/ce.v27i0.87274 copy

DIABETIC KETOACIDOSIS IN CHILDREN AND ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS AND ASSOCIATED RISK FACTORS

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

to estimate the prevalence and risk factors of diabetic ketoacidosis in children and adolescents with Type 1 Diabetes Mellitus.

Method

an epidemiological, cross-sectional and cohort study that analyzed the medical charts of children and adolescents with Type 1 Diabetes Mellitus admitted over a 10-year period to a public reference hospital in the municipality of Campina Grande, Brazil, from 2009 to 2019. The data were analyzed by means of descriptive statistics, both bivariate and multivariate through Poisson regression.

Results

130 medical charts were analyzed, of which 46.2% presented diabetic ketoacidosis. The independent variables that significantly and jointly impacted on the outcome were the following: age, infection, diet error and error in insulin dosage.

Conclusion

diabetic ketoacidosis was a common finding in children and adolescents with Type 1 Diabetes Mellitus. The results contribute to Nursing care and allow implementing intervention for the prevention and adequate management of the problem.

DESCRIPTORS:
Diabetic Ketoacidosis; Type 1 Diabetes Mellitus; Child; Adolescent; Nursing Care.

Variables		n				%
Gender
Female		18				72
Male		7				28
Age
60 ┤ 64 years old		6				24
65 ┤ 69 years		12				48
≥70 years		7				28
Mean ± standard deviation		67.6 ±5.04 years old
Marital Status
Married 12						48
Divorced/Separated 6						24
Widowed						16
Single						8
Stable Union						4
Occupation
Retired/Beneficiary						52
Unemployed/Without income						36
Self-employed						12
Education
Incomplete elementary school				10		40
High School complete				7		28
E. elementary complete				5		20
High School incomplete				2		8
Literate				1		4
Monthly income
One minimum wage				11		44
Less than one wage				8		32
Two to three minimum wages				6		24
Above four minimum wages				0		0

Scales	Total Score Average	Standard Deviation (± SD)	Standard Deviation (± SD)	Minimum score (points)	P value
Fear Scale	20.2	±0.17	30	13	<0.001^* * Test t
Perceived Stress Scale	20.7	±1.20	43	0	<0.001^* * Test t

Scores	Fear Scale score stratification		n	%
7 ┤ 19		Little fear	10	40
20 ┤ 26		Moderate fear	13	52
≥ 27		Very afraid	02	8

Items	Average	Standard Deviation (± SD)	P value^*	T-test^ Test t
1. I am very afraid of COVID-19	3.56	1.12	0.07	0.26
2. Thinking about COVID-19 makes me uncomfortable	3.44	0.86	0.07	0.22
3. My hands get wet/cold when I think about COVID-19	2.56	1.08	0.08	0.27
4. I am afraid of dying because of COVID-19	3.16	1.10	0.08	0.27
5. I get nervous or anxious when I see news in newspapers and on social media about COVID-19.	2.92	1.11	0.05^*	0.08
6. I can’t sleep because I’m worried about being infected with COVID-19.	2.20	0.86	0.00^*	0.00^ Test t
7. My heart races or flutters when I think about being infected with COVID-19.	2.44	1.04	0.06	0.19

Items	Average	Standard Deviation (± SD)	P value^*	T-test^**
1. Have you been sad because of something that happened unexpectedly?	2.12	1.09	0.46	0.09
2. Have you felt unable to control the important things in your life?	1.24	1.45	0.44	0.13
3. Have you been feeling nervous and “stressed”?	1.72	1.40	0.47	0.07
4. Have you been dealing successfully with life’s difficult problems?	1.00	1.32	0.03^*	0.00^**
5. Do you feel that you are coping well with important changes taking place in your life?	0.80	0.95	0.03^*	0.00^**
6. Have you felt confident in your ability to solve personal problems?	0.76	1.23	0.24	0.07
7. Do you feel that things are happening according to your will?	2.12	1.20	0.04^*	0.08
8. Do you feel that you couldn’t handle all the things you have to do?	2.04	1.45	0.05^*	0.13
9. Have you been able to control the irritations in your life?	1.20	1.22	0.03^*	0.00^**
10. Do you feel that things are under your control?	1.36	1.31	0.07	0.22
11. Do you get irritated because things that happen are out of your control?	2.20	1.35	0.03^*	0.00^**
12. Do you find yourself thinking about the things you should do?	1.80	1.58	0.03^*	0.00^**
13. Have you been able to control the way you spend your time?	0.92	1.32	0.04^*	0.07
14. Have you felt that difficulties have been piling up to the point that you believe you can’t overcome them?	1.44	1.22	0.06	0.16

Universidade Federal do Paraná Av. Prefeito Lothário Meissner, 632, Cep: 80210-170, Brasil - Paraná / Curitiba, Tel: +55 (41) 3361-3755 - Curitiba - PR - Brazil
E-mail: cogitare@ufpr.br

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