Rare complications of pediatric diabetic ketoacidosis

Area of Science:

• Pediatrics
• Endocrinology
• Neurology

Background:

• Type 1 diabetes (T1D) incidence is increasing globally in children.
• Diabetic ketoacidosis (DKA) affects up to one-third of pediatric T1D cases and is a leading cause of mortality.
• Cerebral edema is a known, albeit rare, complication of DKA in children.

Purpose of the Study:

• To review the pathophysiology, cases, management, and outcomes of rare DKA complications in children.
• To raise awareness among practitioners regarding the diverse systemic effects of DKA in pediatric patients.
• To highlight complications beyond cerebral edema that require monitoring.

Main Methods:

• Literature review of reported cases and existing research on DKA complications in pediatric patients.
• Synthesis of information on pathophysiology, clinical presentation, and treatment strategies.
• Analysis of outcomes associated with various DKA-related sequelae.

Main Results:

• DKA presents with various rare complications including hypercoagulability (stroke, DVT), rhabdomyolysis, pulmonary and GI issues, and long-term cognitive deficits.
• Cerebral edema, while studied, is not the sole serious complication requiring attention.
• The pathophysiology of some DKA complications is still under debate.

Conclusions:

• Pediatricians must be vigilant for a spectrum of acute and chronic complications arising from DKA in the context of rising T1D rates.
• Comprehensive monitoring and management strategies are crucial for improving outcomes in children with DKA.
• Further research into the pathophysiology and long-term effects of DKA is warranted.