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Diabetic ketoacidosis in an Addis Abeba children's hospital
1Department of Paediatrics, Gonder College of Medical Sciences, Addis Abeda University, Ethiopia.
Insights
Diabetic ketoacidosis (DKA) in children is often triggered by infections or missed insulin doses. Prompt treatment and education can prevent severe DKA episodes and reduce mortality in pediatric diabetes patients.
Area of Science:
- Pediatrics
- Endocrinology
- Metabolic Disorders
Background:
- Diabetic ketoacidosis (DKA) is a serious complication of diabetes mellitus.
- Understanding precipitating factors and clinical profiles is crucial for effective management in pediatric populations.
Purpose of the Study:
- To identify the main causes and clinical characteristics of DKA in children.
- To analyze DKA episodes in pediatric patients at the Ethio-Swedish Children's Hospital (ESCH).
Main Methods:
- Retrospective study of 52 DKA episodes in 46 pediatric patients from 1982 to 1988.
- Data collected on patient demographics, diabetes status (newly diagnosed vs. known), precipitating factors, and outcomes.
Main Results:
- Infections were the most common precipitating factor (52%), followed by insulin omission (16%) and parasitic infections (12%).
- DKA occurred in both newly diagnosed (58%) and known diabetic children (42%).
- The overall mortality rate was 6%, exclusively in previously undiagnosed diabetic patients.
Conclusions:
- Infections and insulin omission are key triggers for DKA in pediatric patients.
- Early diagnosis and treatment of infections, alongside robust patient education, are vital for preventing DKA and improving outcomes.
- Undiagnosed diabetes poses a higher mortality risk in DKA cases.
Abstract:
A retrospective study was carried out to determine the precipitating factors and clinical profiles of diabetic ketoacidosis (DKA) among 46 paediatric patients (mean age 9 yrs) with 52 episodes admitted to the Ethio-Swedish Children's Hospital (ESCH) from January 1, 1982 to December 30, 1988. Thirty (58%) episodes occurred in newly diagnosed diabetics and 22 (42%) episodes in known diabetics. The most common precipitating factors were infection (52%), omission of insulin (16%) and parasitic infection (12%). The mortality rate was 6%, with all fatal cases occurring in previously undiagnosed diabetics. Several of these episodes of DKA may have been prevented by prompt and effective treatment of infections and proper health education.