Severe Hypoglycemia in Hospitalized Children with Diabetic Ketoacidosis in Brazzaville

Abstract

Background: Severe hypoglycemia is a lifethreatening iatrogenic complication in the management of diabetic ketoacidosis, however, few studies have described how often this complication occurs. Objective: To identify the risk factors for severe hypoglycemia in children treated for diabetic ketoacidosis and to describe the sociodemographic, clinical characteristics and outcome of these children. Methods: From January 2013 to December 2017, 69 children admitted to pediatric intensive care unit with a diagnosis of diabetic ketoacidosis were enrolled in a retrospective and prospective study. Data of children with and without severe hypoglycemia were compared. Data were analyzed using Epi Info 7.1.5.0. Results: Out of 69 children enrolled, 10 (14.5%) had severe hypoglycemia (girls: 60%, median age 144 months (interquartile range, 108-168 months)). Episodes of severe hypoglycemia occurred during the first 48 hours of hospitalization in 8 (80%) children and during the late night shift in 6 (60%) children. Causes of severe hypoglycemia were: excessive insulin dose (60%), inappropriate infusion solution (70%), failure to properly monitor blood glucose levels (40%). Severe hypoglycemia risk factors were: age < 5 years (p = 0.00004; OR = 42.0 [95% CI: 6.3-279]) and severe malnutrition (p = 0.002; OR = 10.9 [95% CI: 2.4-48.6]). Of 8 (11.6%) children died, 4 had severe hypoglycemia (p = 0.01; OR = 8.8 [95% CI, 1.7-44.8]). Conclusion: The importance and severity of severe hypoglycemia require preventive measures to control risk factors.

Impact of Type 1 Diabetes on Renal Parameters in Children Aged One to 17 at the Mother and Child University Hospital in N’Djamena, Chad

“…The elevation of these markers indicates functional renal failure and can specify the severity of ketoacidosis and guide therapeutic management. The studies of Sanogo showed similar results in Bamako [13].…”