Diabetic ketoacidosis and its outcome in children

Iqra Rashid, Ayesha Amin, Hafiza Fareeha Mushtaq, Muhammad` Sa’d Masood

Abstract


Objective: The idea of this study was o determine the clinical profile, demographic data and outcome of diabetic ketoacidosis (DKA) in children of age less than 18 years diagnosed with T1DM.

Materials and Methods: Clinical presentation, demographic features, clinical presentation and laboratory findings for all the patients suffering from TD1M with DK1, were observed. Patients admitted were of age less than 18.

Results: A total of 60 children of T1DM with DKA were examined. Mean age of cases was 8.9 years with standard deviation of 1.7 years. There were 32 (53.3%) patients between 10 to 18 years of age while 28 (46.6%) were less than 10 years of age. Out of which 20 (33.3%) were male and 40 (66.6%) females. 42 (70%) patients belonged to urban areas and 18 (30%) lived in  rural areas. A total of 30 (50%) cases were newly diagnosed with T1DM. Prominent symptoms recorded at the time of hospitalization were polyuria 48 (80%) and polydispia 42 (70%). Mean blood glucose at the time of admission was 407.35 mg/dl. Recovery time was 22.3 hours. Frequent complications were hypokalemia 22 (36.6%) and hypernateremia 18 (30%).

Conclusions: It’s crucial to make a diagnosis if TD1M earlier to prevent DKA and its complications.


Keywords


Type 1 diabetes mellitus, ketoacidosis, diabetic ketoacidosis

Full Text:

PDF

References


Baker, P & Steck, A 2011, 'The past, present, and future of genetic associations in type 1 diabetes', Curr diabetes reports, vol 11, p. 445.

Bhardwaj, P, Yadav, V & Sharma, M 2017, 'Clinical profile and outcome of the children with diabetic ketoacidosis (DKA) in hilly Himalayan state of north India', Int J Res Med Sci, vol 5, no. 12, pp. 5402-5.

Dunger, D, Sperling, M, Acerini, C, Bohn, D, Daneman, D & Danne, T 2004, 'European Society for Paediatric Endocrinology/Lawson Wilkins Pediatric Endocrine Society consensus statement on diabetic ketoacidosis in children and adolescents', Pediatr, vol 113, no. 1.

Jabbar, A, Farooqui, K, Habib, A, Islam, N, Haque, N & Akhter, J 2004, ' Clinical characteristics and outcomes of diabetic ketoacidosis in Pakistani adults with Type 2 diabetes mellitus', Diabet Med , vol 21, pp. 920-3.

Lange, K, Swift, P, Pankowska, E & Danne, T 2014, 'Diabetes education in children and adolescents', Pediatr Diabetes , vol 25, pp. 77–85.

Lone, S, Siddiqui, E, Muhammad, F, Atta, I, Ibrahim, M & Raza, J 2010, 'Frequency, clinical characteristics and outcome of diabetic ketoacidosis in children with type-1 diabetes at a tertiary care hospital', J Pak Med Assoc, vol 60, pp. 725-9.

Naeem, M 2017, 'Update Regarding Diabetic Ketoacidosis in Children and Controversies in Management', Qual Prim Care, vol 26, no. 2, pp. 49-52.

Naeem, M, Al-Alem, H, Al-Dubayee, M, AlJuraibah, F, Omair, A & Al-Ruwaili, A 2015, 'Characteristics of pediatric diabetic ketoacidosis in patients in Saudi Arabia', Saudi Med J, vol 36, no. 1, pp. 20-5.

Naveed, D, Bilal, N, Nasir, B & Lodhi, B 2009, 'Precipitating factors for diabetic ketoacidosis', KUST Med J, vol 1, pp. 6-8.

Newhook, L, Curtis, J, Hagerty, D, Grant, M, Paterson, A & Crummel, C 2004, 'High incidence of childhood type 1 diabetes in the Avalon Peninsula, Newfoundland, Canada', Diabetes Care , vol 27, pp. 885-8.

Niaz, Z, Razzaq, A, Chaudhary, U, Awais, M, Yaseen, M & Naseer, I 2005, 'Mortality review of diabetic ketoacidosis in Mayo Hospital, Lahore - Pakistan', Biomedica, vol 21, pp. 83-5.

Ogurtsova, K, da Rocha, F, Huang, Y, Linnenkamp, U, Guariguata, L & Cho, N 2017, 'IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040', Diabetes Res ClinPract, vol 128, pp. 40–50.

Onyiriuka, A & Ifebi, E 2013, 'Ketocidosis at diagnosis of type 1 diabetes in children and adolescents: frequency and clinical characteristics', J Diabetes MetabDisord, vol 12, no. 1, p. 47.

Otieno, C, Kayima, J, Omonge, E & Oyoo, G 2005, 'Diabetic ketoacidosis: risk factors, mechanisms and management strategies in sub-Saharan Africa: a review', East Afr Med J, vol 82, no. 12 Suppl, pp. S197– 203.

Pulungan, A, Batubara, J, Tridjaja, B, Soesanti, F, Fadiana, G & Annisa, D 2019, 'Profile of Diabetic Ketoacidosis in Children with Diabetes Mellitus in a Tertiary Care Hospital in Jakarta: A Retrospective Study', Acta Scientific Paediatr , vol 2, no. 2, pp. 24-9.

Pulungan, A, Juwita, E, Pudjiadi, A, Rahmayanti, S & Tsaniya, I 2018, 'Diabetic Ketoacidosis in Adolescents and Children: A Prospective Study of Blood versus Urine Ketones in Monitoring Therapeutic Response', Acta Med Indones , vol 50, no. 1, pp. 46-52.

Qayyum, A, Lone, S, Ibrahim, M, Atta, I & Raza, J 2010, 'Effects of diabetes self management education on glycaemic control in children with insulindependent diabetes mellitus', J Coll Physicians Surg Pak, vol 20, pp. 802-5.

Razavi, Z 2010, 'Frequency of ketoacidosis in newly diagnosisd type 1 diabetic children', Oman Med J, vol 25, no. 2, pp. 114–7.

Razavi, Z & Hamidi, F 2017, 'Diabetic Ketoacidosis: Demographic Data, Clinical Profile and Outcome in a Tertiary Care Hospital', Iran J Pediatr , vol 27, no. 3, p. e7649.

Schober, E, Rami, B & Waldhoer, T 2010, 'Austrian Diabetes Incidence Study G. Diabetic ketoacidosis at diagnosis in Austrian children in 1989-2008: a population-based analysis', Diabetologia, vol 53, no. 6, pp. 1057–61.

Sheikh, A & Malloush, A 2009, 'Diabetic ketoacidosis: more cases seen during summer vacation', Pak J Med Sci , vol 25, pp. 512-5.

Shera, A, Miyan, Z, Basit, A, Maqsood, A, Ahmadani, M & Fawwad, A 2008, 'Trends of type 1 diabetes in Karachi, Pakistan. ', Pediatr Diabetes, vol 9, pp. 401-6.

Varadajan, P & Suresh, S 2015, 'Delayed diagnosis of diabetic ketoacidosis in children – a cause for concern', Int J Diabetes Dev C, vol 32, no. 2, pp. 66-70.

Wolfsdorf, J, Glaser, N, Agus, M, Fritsch, M, Hanas, R & Rewers, A 2018, 'ISPAD Clinical Practice Consensus Guidelines 2018: Diabetic ketoacidosis and the hyperglycemic hyperosmolar state', Pediatr Diabetes, vol 19, no. Suppl.27, pp. 155–77.


Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.