A Clinical, Demographic, Biochemical and Outcome Prole of DiabeticKetoacidosis in Children with Type 1 Diabetes Mellitus
Abstract
Background: Type 1 Diabetes mellitus is one of the most common chronic, endocrine-metabolicsyndrome of children and adolescents. India accounts for most of the children with T1DM in theSoutheast Asia region. The present study was intended to study the clinical, demographic,biochemical and outcome profile of the children admitted with Diabetic ketoacidosis (DKA).
Materialand methods: A prospective, descriptive, observational study was conducted in the PICU tertiarycare hospital over one year. A total of 54 cases admitted of age group 6 months to 14 years withDKA were included and categorized in mild, moderate and severe categories. Various clinical,demographic, biochemical parameters were compared for the association between severity and finaloutcome.
Result: Out of 54 cases admitted with DKA, 39 (72.2%) patients were female, most of thecases belonged to rural areas. Dehydration (83.3%), nausea/vomiting (77.7%), Kussmaul'sbreathing (72.2%) were common presenting symptoms and signs of DKA. The severity of DKA wassignificantly associated with gender, area of residence, socioeconomic status, B.M.I. of the patient,presence of infection, insulin omission, DKA on 1st episode, presence of diarrhea, presence of shock,poor G.C.S. on admission and time required for resolution of DKA (p-value <0.05 for each). Themortality rate was 7.4%.
Conclusion: In our study, the most common precipitating factor observedfor DKA was an infection. For the long-term management strategy, education of the patients andtheir parents regarding infection control, regular blood sugar monitoring and proper Insulin dosingappear to be promising tools.
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References
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