The risk of diabetic ketoacidosis, a major complication of type 1 diabetes in children, may be reduced with the regular assistance of a primary health care provider, according to a study published in CMAJ (Canadian Medical Association Journal).
Type 1 diabetes mellitus is a common chronic childhood disease. If untreated, it can result in DKA, the most common cause of death in children with type 1 diabetes. DKA occurs as the body breaks downs muscle and fats for energy in place of sugar, releasing fatty acids (ketones) into the blood.
"Having a regular primary care provider was associated with a reduced risk of DKA at diabetes onset, but this protection reached statistical significance only among those 12-17 years of age," writes Dr. Meranda Nakhla, Montreal Children's Hospital and the Research Institute of the McGill University Health Centre, Montreal, Quebec, with coauthors. "Adolescents who had a regular family physician or pediatrician were 31% less likely or 38% less likely, respectively, to present with DKA relative to those without regular primary care."
"Our study provides further evidence for policy-makers about the need to develop and strengthen initiatives that promote primary care for children," write the authors. "Our results highlight the need to develop targeted interventions for children under 12 years of age, including increasing public and physician awareness (through educational campaigns) about the symptoms of diabetes in this age group."
Dr. Astrid Guttmann, The Hospital for Sick Children (SickKids) and the Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, writes the "study serves as an example of one of the many important child health outcomes that are both sensitive to access to timely care and independently related to socioeconomic health status."