Mild and severe diabetic ketoacidosis in children: a report of two cases
Abstract
Diabetic ketoacidosis (DKA) is a severe complication of diabetes mellitus (DM) in children caused by insulin deficiency. This condition is often unidentified or diagnosed late, and treated with inadequate therapy. Diabetic ketoacidosis can lead to several complications, the most fatal being cerebral edema. We present two cases of DKA with different clinical presentation and severity. Early identification and proper management of DKA can help improve outcomes and avoid complications.
References
2. Wolfsdorf JI, Glaser N, Agus M, Fritsch M, Hanas R, Rewers A, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Pediatr Diabetes. 2018;27:155-77. DOI: https://doi.org/10.1111/pedi.12701.
3. Andriyani D, Wahyudhi A, Anggriawan SL. Diabetic ketoacidosis with acute kidney injury in prepubertal children: a report on two cases. Paediatrica Indonesiana. 2017;56:360-8. DOI: https://doi.org/10.14238/pi56.5.2016.360-8.
4. Raghupathy P. Diabetic ketoacidosis in children and adolescents. Indian J Endocrinol Metab. 2015;19:S55-7. DOI: https://doi.org/10.4103/2230-8210.155403.
5. Couper JJ, Haller MJ, Greenbaum CJ, Ziegler AG, Wherrett DK, Knip M, et al. ISPAD clinical practice consensus guidelines 2018: stages of type 1 diabetes in children and adolescents. Pediatr Diabetes. 2018;27:20-7. DOI: https://doi.org/10.1111/pedi.12734.
6. Rose KL, Pin CL, Wang R, Fraser DD. Combined insulin and bicarbonate therapy elicits cerebral edema in a juvenile mouse model of diabetic ketoacidosis. Pediatr Res. 2007;61:301-6. DOI: https://doi.org/10.1203/pdr.0b013e318030d193.
7. Kotori VM, Gashi N, Toro H. Severe ketoacidocis at onset of type 1 diabetes in children due to late diagnosis. Diabetologia Croatica. 2007;36:59-65.
8. Soto-Rivera CL, Asaro LA, Agus MS, DeCourcey DD. Suspected cerebral edema in diabetic ketoacidosis: is there still a role for head CT in treatment decisions? Pediatr Crit Care Med. 2017;18:207-12. DOI: https://doi.org/10.1097/PCC.0000000000001027
9. Vavilala MS. Imaging for cerebral edema in diabetic ketoacidosis, time to zap the CT? Pediatr Crit Care Med. 2017;18:281-2. DOI: https://doi.org/10.1097/PCC.0000000000001037.
Copyright (c) 2022 Vini Jamarin, Nanis Sacharina Marzuki
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Accepted 2022-08-10
Published 2022-08-10