The impact of diabetic ketoacidosis and age on behavior six months post-diagnosis in children with type 1 diabetes

Scratch, S.E., Nadebaum, C., Northam, E.A., Cameron, F.J., Diabetic Ketoacidocis and Brain Injury Study Group, , & Wellard, R.M. (2010) The impact of diabetic ketoacidosis and age on behavior six months post-diagnosis in children with type 1 diabetes. In 36th Annual Meeting of the International Society for Pediatric and Adolescent Diabetes (ISPAD), 27 - 30 October 2010, Buenos Aires, Argentina.

View at publisher


Objectives: Children with type 1 diabetes mellitus (DM1) may be at increased risk of psychosocial and adjustment difficulties. We examined behavioral outcomes six months post-diagnosis in a group of children with newly diagnosed DM1.

Methods: This study formed part of a larger longitudinal project examining pathophysiology and neuropsychological outcomes in diabetic patients with or without diabetic ketoacidosis (DKA). Participants were 61 children (mean age 11.8 years, SD 2.7 years) who presented with a new diagnosis of DM1 at the Royal Children’s Hospital, Melbourne. Twenty-three (11 female) presented in DKA and 38 (14 female) without DKA. Parents completed the behavior assessment system for children, second edition six months post-diagnosis.

Results: There was a non-linear relationship between age and behavior. Internalising problems (i.e. anxiety depression, withdrawal) peaked in the transition from childhood to adolescence; children aged 10–13 years had elevated rates relative to the normal population (t = 2.55, P = 0.018). There was a non-significant trend for children under 10 to display internalising problems (P = 0.052), but rates were not elevated in children over 13 (P = 0.538). Externalising problems were not significantly elevated in any age group. Interestingly, children who presented in DKA were at lower risk of internalising problems than children without DKA (t = 3.83, P < 0.001). There was no effect of DKA on externalising behaviors.

Conclusions: Children transitioning from childhood to adolescence are at significant risk for developing internalising problems such as anxiety and lowered mood after diagnosis of DM1. Somewhat counter-intuitively, parents of children presenting in DKA reported fewer internalising symptoms than parents of children without DKA. These results highlight the importance of monitoring and supporting psychosocial adjustment in newly diagnosed children even when they seem physically well.

Impact and interest:

Search Google Scholar™

Citation counts are sourced monthly from Scopus and Web of Science® citation databases.

These databases contain citations from different subsets of available publications and different time periods and thus the citation count from each is usually different. Some works are not in either database and no count is displayed. Scopus includes citations from articles published in 1996 onwards, and Web of Science® generally from 1980 onwards.

Citations counts from the Google Scholar™ indexing service can be viewed at the linked Google Scholar™ search.

ID Code: 75020
Item Type: Conference Item (Poster)
Refereed: Yes
Additional Information: R.M. Wellard is a member of the Diabetic Ketoacidocis and Brain Injury Study Group
Keywords: diabetes, ketoacidosis, MRI
DOI: 10.1111/j.1399-5448.2010.00716.x
ISSN: 1399-5448
Subjects: Australian and New Zealand Standard Research Classification > BIOLOGICAL SCIENCES (060000)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000)
Divisions: Current > Schools > School of Chemistry, Physics & Mechanical Engineering
Current > Institutes > Institute of Health and Biomedical Innovation
Current > QUT Faculties and Divisions > Science & Engineering Faculty
Copyright Owner: Copyright 2010 John Wiley & Sons A/S
Deposited On: 17 Aug 2014 23:07
Last Modified: 17 Aug 2014 23:07

Export: EndNote | Dublin Core | BibTeX

Repository Staff Only: item control page