J Korean Diabetes.  2017 Sep;18(3):193-204. 10.4093/jkd.2017.18.3.193.

Clinical and Laboratory Characteristics of Pediatric Diabetic Ketoacidosis: A Single-Center Study

• Choi IH
• Kim MS
• Hwang PH
• Lee DY

• KMID: 2390874
• DOI: http://doi.org/10.4093/jkd.2017.18.3.193

Abstract

BACKGROUND
Diabetic ketoacidosis (DKA) is an acute complication of pediatric type 1 diabetes mellitus (T1DM). We aimed to determine the risk factors and clinical characteristics of children and adolescents with DKA.
METHODS
We retrospectively evaluated 59 episodes of DKA in 43 patients who were hospitalized for DKA between January 2006 and December 2015. DKA was classified as mild, moderate, or severe, according to patient history of DKA. The clinical and laboratory characteristics of these subgroups were compared.
RESULTS
The average patient age was 11.98 ± 4.40 years (range, 1.3~17.9 years). Moderate episodes were the most common, with 21 episodes (35.6%), followed by 19 severe (32.2%) and 19 mild episodes (32.2%). Significant differences were observed between the subgroups regarding their characteristics of aggravated. Severe DKA episodes were more often observed during the winter season. Recurrent DKA cases were determined in 31 episodes (52.5%) who were significantly older, had higher body mass index, and lower serum C-peptide levels than the newly diagnosed DKA group. Female patients experienced severe and moderate cases more frequently (P = 0.041), which included two deaths. Only blood glucose levels were significantly higher in these fatal cases (P = 0.022).
CONCLUSION
Even among the patients who had previously experienced DKA and older children with low serum C-peptide levels, there was no reduction in the severity of DKA. We recommend that patients with DKA be carefully treated and continuously informed regarding the importance of maintaining proper blood glucose levels, regardless of their previous history of DKA, age, or regularity of insulin therapy.

Keyword

Child; Diabetic ketoacidosis; Diabetes mellitus; Type 1

MeSH Terms

Adolescent
Blood Glucose
Body Mass Index
C-Peptide
Child
Diabetes Mellitus
Diabetes Mellitus, Type 1
Diabetic Ketoacidosis*
Female
Humans
Insulin
Retrospective Studies
Risk Factors
Seasons
Blood Glucose
C-Peptide
Insulin

Figure

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  Fig. 1. Seasonal distribution of diabetic ketoacidosis severity (A) and prior diabetic ketoacidosis history (B) on the day of admission. Months are numbered from 1∼12 for January∼December, respectively. DKA, diabetic ketoacidosis.

Reference

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