Diabetic Ketoacidosis In Adolescents Research Articles

Fatores que predispõem a cetoacidose diabética em adolescentes

A Cetoacidose Diabética definida como uma complicação por deficiência de insulina e está relacionada principalmente a Diabetes Mellitus tipo 1. Essa patologia é considerada uma emergência médica e requer cuidados imediato sendo motivo de mortes e incapacidades permanecente de adolescente; tendo influencia sociodemográfica para seu acometimento, sendo nos países desenvolvidos a taxa de mortalidade é de 2 a 5% e nos em desenvolvimento chega de 6 a 24%. O estudo objetiva descrever os fatores que predispõem à cetoacidose diabética em adolescentes evidenciados nas publicações científicas. Trata-se de uma revisão integrativa da literatura com abordagem qualitativa; os descritores foram consultados através dos Descritores em Ciências da Saúde (DeCS) e no Medical Subject Headings (MeSH). Seus respectivos cruzamentos foram realizados por meio da Plataforma da Biblioteca Virtual em Saúde e no portal PubMed; utilizando os operadores booleanos "AND", “OR”. Identificaram-se 10.069 publicações, das quais, após aplicação dos critérios de inclusão e exclusão, foram selecionados para a amostra desta revisão 14 artigos. Dez (71,4%) foram identificados na MEDLINE/Pubmed, dois (14,3%) na LILACS e dois (14,3%) na SCIELO. Em relação ao aspecto clínico e social, a não adesão ao tratamento da diabetes, o tratamento incorreto e apresentação de quadros infecciosos; o menor nível socioeconômico, as famílias sem histórico dessa patologia, o menor nível de educação paterna são fatores predisponentes para Cetoacidose Diabética. Para intervenções efetivas, é importante que as equipe de saúde sistematize seu processo de trabalho e ações conforme o preconizado, visando garantir a saúde e diminuir a morbi-mortalidade relacionada à doença.

The cost of treating diabetic ketoacidosis in an adolescent population in the UK: a national survey of hospital resource use.

Adolescents with Type 1 diabetes commonly experience episodes of ketoacidosis. In 2014, we conducted a nationwide survey on the management of diabetic ketoacidosis in young people. The survey reported how individual adolescents with diabetes were managed. However, the costs of treating diabetic ketoacidosis were not reported. Using this mixed population sample of adolescents, we took a 'bottom-up' approach to cost analysis aiming to determine the total expense associated with treating diabetic ketoacidosis. The data were derived using the information from the national UK survey of 71 individuals, collected via questionnaires sent to specialist paediatric diabetes services in England and Wales. Several assumptions had to be made when analysing the data because the initial survey collection tool was not designed with a health economic model in mind. The mean time to resolution of diabetic ketoacidosis was 15.0h [95% confidence interval (CI) 13.2, 16.8] and the mean total length of stay was 2.4days (95% CI 1.9, 3.0). Based on data for individuals and using the British Society of Paediatric Endocrinology and Diabetes (BSPED) guidelines, the cost analysis shows that for this cohort, the average cost for an episode of diabetic ketoacidosis was £1387 (95% CI 1120, 1653). Regression analysis showed a significant cost saving of £762 (95% CI 140, 1574; P=0.04) among those treated using BSPED guidelines. We have used a bottom-up approach to calculate the costs of an episode of diabetic ketoacidosis in adolescents. These data suggest that following treatment guidelines can significantly lower the costs for managing episodes of diabetic ketoacidosis.

Diabetic Ketoacidosis: An Uncommon Manifestation of Pesticide Poisoning

Diabetic ketoacidosis in adolescents can be a cause of severe morbidity and mortality, especially if unrecognized at the time of first diagnosis (1). We present a 15-year-old girl who was initially treated for “diabetic ketoacidosis” with further worsening of her general condition. This delayed recovery, coupled with focused investigations, finally led us to a diagnosis and the appropriate management of an intentional overdose with organophosphorous (OP) pesticide, presenting as diabetic ketoacidosis. Our aim is also to raise awareness of the effects of organophosphates, widely used as pesticides, on glucose metabolism, and its potential implications in the epidemic of diabetes worldwide. A 15-year-old girl was admitted with a 10-h history of giddiness, vomiting, and drowsiness. She was apparently well the evening prior to her admission. Clinical examination …