Thiamine Deficiency in Children with Type I Diabetes Mellitus and Ketoacidosis Hospitalized in a Referral Pediatric Hospital in 2019 - 2020

Abstract

Background: Thiamine is an essential coenzyme, reduced in type I and II diabetes. There has been little research on thiamine levels and their role in children with diabetic ketoacidosis (DKA). Objectives: This study aimed to analyze thiamine deficiency in this patient group. Methods: A cross-sectional study was done in 2019 - 2020 in Children’s Medical Center, a pediatric referral hospital with 350 beds, on children with type I diabetes hospitalized in the PICU for DKA. A blood sample was taken on admission to obtain biochemical laboratory parameters and measure electrolytes and thiamine levels. Blood gases were taken regularly, and the first pH and first bicarbonate level were measured. The time required for pH normalization and recovery from acidosis was recorded. Hospital stay duration was also calculated. Plasma thiamine measurement was done with a Human Vitamin B1 (VB1) ELISA Kit from Bioassay Technology Laboratory. Data were analyzed with SPSS version 22 software. Results: Of 62 patients, 56.5% were females with a mean age of 63 months. Thiamine level was 1.61 ± 1.17 μg/dL, and 66.1% of the patients were thiamine deficient. Hospitalization duration was 3.52 ± 0.41 days in the thiamine deficient group and 2.47 ± 0.32 days in the normal group (P value < 0.05). The white blood cell (WBC) count was higher in thiamine deficient patients. Thiamine levels were independently and inversely related to age. Conclusions: Thiamine deficiency is common among children with DKA and could be a prognostic and therapeutic factor.