Diabetic keto acidosis—among children with established diabetes from a pediatric tertiary care Institute

Abstract

A prospective observational study was undertaken from a pediatric tertiary care Institute at Chennai, among the diabetic keto acidosis (DKA) episodes in children with established diabetes mellitus (DM) and DKA in new onset DM between Jun 2009 and Jan 2012. Clinical and laboratory parameters, predisposing factors, complications and the outcome were compared between the two groups. Among the 97 episodes of DKA treated during the study period 42(43.3 %) were among the known diabetic children. Overall 32 children accounted for 42 episodes of DKA. Female preponderance was encountered among DKA episodes in children with established diabetes. All children with 2 or more episodes of DKA were females. Precipitating factors were infections in 47 % and poor compliance to therapy in 28 % . Difficult or unstable family circumstances were encountered in 40 % of children. Female preponderance (P-0.001), severe DKA(P-0.003), shorter duration of illness(P-0.009), skin infections (P-0.028) and higher insulin requirement (P-0.003) showed a statistically significant difference in DKA among children with established DM in comparison to DKA among new onset DM. The metabolic parameters and complications were almost similar to newly diagnosed diabetic children. Mortality in DKA among established diabetic children is 7.1 % in comparison to 12.7 % in new onset DKA.