Seasonal Variation of Diabetic Ketoacidosis among Children and Adolescents with Type 1 Diabetes: A Single-Center Tertiary Experience.
Diabetic ketoacidosis (DKA) seasonal variations among children and adolescents with type 1 diabetes mellitus (T1DM) have been widely studied; however, findings remain inconsistent. Although several studies reported a higher incidence during colder months, others showed no consistent patterns. This study investigated whether DKA frequency and severity vary across seasons, particularly in humid cities.
This retrospective cohort analyzed children and adolescents with T1DM admitted to a tertiary hospital with DKA (2015-2025). Data included demographics, seasonal admission trends, clinical severity, and outcomes. Statistical analyses involved the Chi-square and ANOVA tests.
A total of 369 DKA cases were analyzed, with mean age of 14.7 years and 62.6% were females. Most had established T1DM (88.6% with prior DKA episodes). Severe cases showed significantly higher heart rates, lower GCS scores (p < 0.001), higher HbA1c levels (p = 0.001), longer hospital (p = 0.007) and ICU (p = 0.003) stays. Diastolic blood pressure also correlated with severity (p = 0.036). Although DKA severity showed no significance seasonal association (p = 0.865), winter peak was observed, suggesting confounding factors or bias in seasonal patterns.
The DKA admission peaked in winter, particularly in December; however, this trend was not clinically significant. Confounding factors, including infection or delayed care, may explain this variation. The findings emphasize focusing on modifiable patient factors, including year-round glycemic control, education, and timely interventions, to reduce DKA recurrence.
This retrospective cohort analyzed children and adolescents with T1DM admitted to a tertiary hospital with DKA (2015-2025). Data included demographics, seasonal admission trends, clinical severity, and outcomes. Statistical analyses involved the Chi-square and ANOVA tests.
A total of 369 DKA cases were analyzed, with mean age of 14.7 years and 62.6% were females. Most had established T1DM (88.6% with prior DKA episodes). Severe cases showed significantly higher heart rates, lower GCS scores (p < 0.001), higher HbA1c levels (p = 0.001), longer hospital (p = 0.007) and ICU (p = 0.003) stays. Diastolic blood pressure also correlated with severity (p = 0.036). Although DKA severity showed no significance seasonal association (p = 0.865), winter peak was observed, suggesting confounding factors or bias in seasonal patterns.
The DKA admission peaked in winter, particularly in December; however, this trend was not clinically significant. Confounding factors, including infection or delayed care, may explain this variation. The findings emphasize focusing on modifiable patient factors, including year-round glycemic control, education, and timely interventions, to reduce DKA recurrence.