Paediatric and adolescent diabetic ketoacidosis

Abstract

Diabetic ketoacidosis (DKA) is one of the two acute emergency situations in those who have diabetes mellitus. DKA should be identifiable and is often preventable. Any associated complications of DKA should also be preventable with proper education and treatment. Awareness of presenting signs and symptoms, on the part of the general public, primary care providers and emergency department personnel, should help minimise the severity of DKA through earlier diagnosis and focusing on appropriate physiologic treatment as well as close, ongoing monitoring to minimise potential lethal DKA complications such as cerebral oedema. Missed diagnosis, late diagnosis, inappropriate treatment, delayed treatment and lack of appropriate monitoring are usually associated with more morbidity and mortality as well as increased hospital costs. Insulin treatment is only one part of DKA management. Fluid and electrolyte monitoring and treatment are often a critical aspect of such management. All aspects of DKA recognition, treatment and prevention must be emphasised to decrease DKA morbidity and mortality around the world.

ISPAD Clinical Practice Consensus Guideline: Diabetic ketoacidosis in the time of COVID ‐19 and resource‐limited settings‐role of subcutaneous insulin

“…This may assist in identification of children at risk of DKA, help in prevention of DKA, and avoid ED visits 11 . Families should be educated to not omit insulin, remain hydrated, and treat the underlying symptoms of an intercurrent illness 12‐14 , as well general advice regarding healthy eating and continuing physical activity at home. Frequent monitoring for BG (and ketones when indicated) should be encouraged.…”