Patient selection: <= 19 years of age with type 1 diabetes mellitus
Previously reported risk factors for acute complications (page 2512):
(1) poor glycemic control
(2) family and school problems (which often correlates with psychiatric disorders)
(3) low socioeconomic status
(4) ethnicity (which may correlate with low socioeconomic status, although other factors may be operating)
(5) gender
(6) lack of adequate health insurance (which often correlates with low socioeconomic status)
Risk factors for ketoacidosis:
(1) girls >= 7 years of age
(2) in children < 13 years of age:
(2a) higher hemoglobin A1c (which correlates with poor glycemic control)
(2b) higher reported insulin dose (> 1 U/kg/day based on Table 1, page 2513)
(3) in children >= 13 years of age:
(3a) higher hemoglobin A1c (marker of poor glycemic control)
(3b) higher reported insulin dose
(3b) underinsurance
(3d) psychiatric disorder
Risk factors for severe hypoglycemia:
(1) decreases with age in girls
(2) in children < 13 years
(2a) duration of diabetes in years (per 5 year interval)
(2b) underinsurance
(3) in children >= 13 years of age:
(3a) duration of diabetes in years (per 5 year interval)
(3b) underinsurance
(3c) lower hemoglobin A1c
(3d) psychiatric disorder
80% of complications in occurred in the 20% of children with recurrent events (an interesting variation on the 90-10 rule in management: 90% of problems are caused by 10% of people).
