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Cortisol Levels in Children With Diabetic Ketoacidosis Associated With New-Onset Type 1 Diabetes Mellitus

Kristen M Williams1, Pamela Fazzio2, Sharon E Oberfield1

  • 11 Columbia University Medical Center, New York, NY, USA.

Clinical Pediatrics
|February 2, 2017
PubMed

Insights

This study found that children with diabetic ketoacidosis (DKA) generally have adequate cortisol levels, but low levels may occur. Adrenal insufficiency (AI) should still be considered in DKA management.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Diabetes Mellitus Research

Background:

  • Limited data exists on cortisol levels in pediatric diabetic ketoacidosis (DKA).
  • Untreated adrenal insufficiency (AI) can exacerbate DKA outcomes.
  • Assessing cortisol is crucial for comprehensive DKA management in children.

Purpose of the Study:

  • To investigate serum cortisol levels in children diagnosed with DKA and new-onset type 1 diabetes mellitus.
  • To determine the relationship between cortisol levels and clinical/laboratory parameters in pediatric DKA.
  • To evaluate the prevalence of adrenal insufficiency in this patient cohort.

Main Methods:

  • Cross-sectional study design.
  • Inclusion of 28 children with DKA and new-onset type 1 diabetes mellitus over a 5-year period.
  • Measurement of serum cortisol levels, hemoglobin A1c, and serum pH.

Main Results:

  • Mean cortisol level was 40.9 µg/dL (range: 7.8–119 µg/dL).
  • Cortisol levels showed an inverse association with serum pH (P = .007).
  • No significant difference in clinical outcomes was observed in patients with cortisol levels < 18 µg/dL.

Conclusions:

  • The study did not find widespread evidence of diminished cortisol reserve in children with DKA.
  • While generally adequate, the potential for AI in pediatric DKA warrants clinical consideration.
  • Further research may clarify the role of AI in DKA pathogenesis and management.

Keywords:
adrenal insufficiencyautoimmunecortisoldiabetic ketoacidosistype 1 diabetes mellitus

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