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[Diabetic ketoacidosis in childhood]
D Krikovszky1, A Luczay, A Körner
1I. Gyermekklinika, Semmelweis Orvostudományi Egyetem, Budapest.
Insights
Diabetic ketoacidosis (DKA) is a severe complication in children with insulin-dependent diabetes. This study found no link between DKA severity and hospital stay duration, though treatment times varied.
Area of Science:
- Pediatrics
- Endocrinology
- Metabolic Disorders
Context:
- Diabetic ketoacidosis (DKA) is a life-threatening complication of insulin-dependent diabetes mellitus, frequently leading to hospitalization in children.
- The mortality rate for DKA has remained stagnant at 1-2% since the 1970s.
- This study retrospectively analyzed 89 pediatric patients admitted with DKA between 1992 and 1997.
Purpose:
- To compare metabolic parameters, ketoacidosis causes, and hospital stay duration between previously diagnosed and newly diagnosed diabetic children.
- To analyze laboratory findings, intravenous fluid and insulin requirements, and hospital stay length in patients with mild-to-moderate versus severe DKA.
- To examine consciousness levels and co-existing complications in pediatric DKA patients.
Summary:
- Analysis of 89 pediatric DKA cases revealed no significant relationship between disease severity and hospital treatment duration.
- A significant difference was observed solely in the duration of intravenous insulin administration, excluding pH and base excess.
- Even children with previously diagnosed diabetes required over 7 days of hospitalization for DKA treatment.
Impact:
- Highlights the prolonged hospitalization required for pediatric DKA, irrespective of initial severity or prior diagnosis.
- Suggests potential areas for optimizing intravenous insulin therapy protocols in pediatric DKA management.
- Underscores the persistent challenge of DKA as a critical complication in pediatric diabetes care.
Abstract:
Diabetic ketoacidosis is the most serious acute complication of insulin-dependent diabetes mellitus and the most frequent reason for hospital admission of diabetic children. The most frequent cause of death of these patients is also the diabetic ketoacidosis. The mortality rate of the disease has not changed since the seventies (1-2%). In this work, the data of 89 patients with diabetic ketoacidosis were analyzed. These patients were admitted to the 1. Department of Pediatrics of the Semmelweis University of Medicine between 1992-1997. The data (metabolic parameters, the causes of ketoacidosis and the length of hospital stay) of previously known diabetic children was compared with the data of previously unknown diabetic children. Our patients were divided in 2 groups: serious (n = 11), and mild-to-moderate (n = 48) acidosis. Their laboratory findings, their intravenous infusion-, and insulin demand and the length of their hospital stay were compared. The state of consciousness at their hospitalisation and the concomitant complications were also examined. Significant difference was found only in the duration of intravenous insulin administration (with the exception of pH and BE, of course). There was no relationship between the seriousness of the disease and the duration of hospital treatment. It is noteworthy that even the previously known diabetic children with the shortest hospitalization spent more than 7 days at the department.