Clinical profile and outcome of diabetic ketoacidosis in children.
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Date
2009-01
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Abstract
Background. There is little information on the clinical
profile and outcome of children with diabetic ketoacidosis in
India. We analysed the data of children managed by us at a
tertiary care hospital.
Methods. We retrospectively analysed the case records of
21 children (13 boys and 8 girls) with diabetic ketoacidosis
admitted to our hospital from January 2004 to August 2008.
They were managed using a standard protocol including
intravenous fluids and insulin infusion. Blood glucose, serum
electrolytes, blood urea, arterial blood gases and urinary
ketones were monitored at regular intervals. The outcomes
were assessed.
Results. The median age at presentation was 8 years and
17 children (80%) were detected to have diabetes mellitus at
the time of presentation. Twelve children (57%) presented
with severe diabetic ketoacidosis. Polyuria with polydipsia was
the commonest clinical presentation (17). All of them had
elevated HbA1C levels. The average length of stay in the
paediatric intensive care unit was 2.9 days. The median time
for the arterial blood gases to become normal was 19 hours
and for urinary ketones to become non-detectable was 28
hours. None of the children received bicarbonate and there
were no complications or mortality. All the children were
doing well on follow up at 3 months.
Conclusion. The outcome of active management of
diabetic ketoacidosis in children is rewarding. The use of a standard protocol for management was associated with no complications or mortality in our series.
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Ganesh Ramaswamy, Arvindkumar R, Vasanthi Thiruvengadam. Clinical profile and outcome of diabetic ketoacidosis in children. National Medical Journal of India. 2009 Jan-Feb; 22(1): 18-19.