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A DIFFERENT PERSPECTIVE OF ELEVATED LACTATE IN PEDIATRIC PATIENTS WITH DIABETIC KETOACIDOSIS

E Unal1, A G Pirinccioglu2, S Y Yanmaz2

  • 1Dicle University, Faculty of Medicine, Department of Pediatric Endocrinology, Diyarbakir, Turkey.

Acta Endocrinologica (Bucharest, Romania : 2005)
|July 21, 2020
PubMed

Insights

Lactic acidosis is common in pediatric diabetic ketoacidosis (DKA). High lactate levels in DKA patients do not necessarily indicate a poor prognosis and may even offer protection against brain damage.

Area of Science:

  • Pediatric Endocrinology
  • Critical Care Medicine

Background:

  • Diabetic ketoacidosis (DKA) is a serious complication of diabetes in children.
  • Lactic acidosis can occur in DKA, but its prognostic significance is not fully understood.

Purpose of the Study:

  • To determine the frequency of lactic acidosis in pediatric DKA patients.
  • To evaluate the prognostic significance of lactic acidosis in this population.

Main Methods:

  • Retrospective study of 56 pediatric patients (2-18 years) admitted to the PICU for DKA.
  • Inclusion criteria: serum glucose >200 mg/dL, ketonuria, venous pH ≤7.1, bicarbonate <15.

Main Results:

  • Lactic acidosis was observed in pediatric DKA patients.
  • No significant difference in DKA recovery time between low and high lactate groups (16.05 ± 6.25 h vs. 13.57 ± 8.34 h).
  • A negative correlation was found between lactate levels and DKA recovery time.

Conclusions:

  • Lactic acidosis is a frequent finding in pediatric DKA.
  • Unlike in sepsis, lactic acidosis in DKA is not always associated with poor prognosis or mortality.
  • Elevated lactate levels may potentially protect against cerebral edema and damage in DKA.
Abstract

Keywords:
Brain edemachildrendiabetic ketoacidosisintensive carelactate

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