PROFILE OF CHILDHOOD DIABETIC KETOACIDOSIS - A SINGLE CENTRE EXPERIENCE
Anki Reddy, Amaresh Reddy* and Parul Jain
ABSTRACT
Context: Diabetic ketoacidosis (DKA) is a common paediatric emergency. Aims: To present the patient profile
of childhood DKA Methods: This is a retrospective study of 26 children presenting with DKA to pediatric
emergency. All the patients had random plasma glucose, serum electrolytes, renal function tests, arterial blood gas
analysis, hemogram, complete urine examination, chest radiograph done. Results: Of the 26 patients studied 20
were girls. 42% of the children were new onset type 1 diabetes presenting with DKA. 70% were comatose at the
time of presentation. Mean age of patients was 8.9 ±4.52 years. Severe, moderate and mild DKA was present in
13, 8 and 5 patients respectively. The precipitating factor for DKA are skipping the dose in 9, acute febrile illness
due to respiratory tract infection in 9, both skipping the dose and respiratory tract infection in 2, diarrhea in 1 and
5 didn’t have a precipitating factor. 10 out of 26 patients had hyperosmolar state at the time of presentation. The
mean plasma glucose, PH, bicarbonate, anion gap and osmolarity were 372 ±108 mg/dl, 7.11 ±0.27, 13.8 ± 5.9
meq/l, and 307 ±15.8mosm/l respectively. Mean sodium and potassium were 140 ±10.8 meq/l and 3.8± 0.88 meq/l
respectively. Hypokalemia is the most common complication seen in 21 out of 26 patients. The mean hospital
stay was 9.8 ± 5.65 days. One patient died of pneumonia and sepsis with shock. Conclusions: Type 1 diabetes can
present with DKA as first manifestation, 1/3 of patients had hyperosmolar state and hypokalemia is the most
common complication.
Keywords: Diabetic ketoacidosis, type 1 diabetes mellitus, hypokalemia, cerebral edema.
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