Precipitating factors, clinical features and outcome of diabetic ketoacidosis in children and adolescents admitted in a tertiary care hospital in Dhaka

Fauzia Mohsin,Gulshan Akhter,Rubaiya Islam,Rumana Shelim,Shahida Akhter,Tahmina Begum

doi:10.3329/bjms.v13i1.17429

Abstract

Background Information: Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with type 1 diabetes mellitus (DM). It is an acute complication of type 1 DM. Objective: This study was designed to identify the precipitating factors, clinical features and immediate outcomes of DKA in children and adolescents. Method: This was a retrospective study which was done in the department of Pediatrics, BIRDEM, from January 2002 to April 2007. Data were collected from the hospital record for all diabetic children below 18 years admitted with DKA. Result: Fourty nine children and adolescents were admitted with DKA. Sixty one percent were known cases and the remaining (39%) were new DM. Majority were female (63%). Most (49%) of the children were between 11- 15 years. Infection was the commonest (49%) precipitating factor followed by insulin omission (24%). Major clinical features were kussmaul breathing (94%) and dehydration (94%).Eighty eight percent patients improved after treatment and mortality was 12%. Conclusion: Infection was the commonest precipitating factor of DKA. Kussmaul breathing and dehydration were the commonest clinical features. Most of the patients improved after treatment.DOI: http://dx.doi.org/10.3329/bjms.v13i1.17429 Bangladesh Journal of Medical Science Vol. 13 No. 01 January2014: 53-57

Highlights

Diabetes mellitus (DM) is one of the main threats to human health in the 21st century
Fourty nine(9.6%) of these admitted patients presented with diabetic ketoacidosis (DKA)
Amongst the total patients with Diabetic ketoacidosis (DKA) with documented etiology, twenty four episodes were precipitated by infection and no cause being documented in 13 of the admissions. (Figure 3) Infections, those of the respiratory tract, were the main precipitating cause for the DKA

Summary

Introduction

Diabetes mellitus (DM) is one of the main threats to human health in the 21st century. Diabetic ketoacidosis (DKA) is an acute complication and a medical emergency in children and adolescents with type 1 diabetes[1]. Precipitating events are new onset diabetes, sepsis, insulin omission, delay in diagnosis and previous episodes of DKA5. Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with type 1 diabetes mellitus (DM). It is an acute complication of type 1 DM. Objective: This study was designed to identify the precipitating factors, clinical features and immediate outcomes of DKA in children and adolescents. Major clinical features were kussmaul breathing (94%) and dehydration (94%).Eighty eight percent patients improved after treatment and mortality was 12%.

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Conclusion