Diabetic Ketoacidosis in Children
Case Report
DOI:
https://doi.org/10.55175/cdk.v51i11.1083Keywords:
Diabetes mellitus, blood sugar, diabetic ketoacidosisAbstract
The incidence of diabetic ketoacidosis (DKA) in children with type 1 diabetes mellitus reaches 1–12 per 100 patients each year. The case is a boy aged 13 years 10 months with chief complaints of weakness and drowsiness. Blood sugar levels 532 mg/dL, blood ketone levels 6.6, blood pH 7.13, HbA1c 19.2%. The principles of DKA management include fluid therapy, insulin, electrolyte balance, treat the underlying disease, and monitor complications.
Downloads
References
Tridjaya B, Yati NP, Faizi M, Marzuki ANS, Moelyo AG, Soesanti F. Konsensus nasional pengelolaan diabetes melitus tipe-1. UKK Endokrinologi Anak dan Remaja. Jakarta: IDAI; 2015.
Glaser N, Fritsch M, Priyambada L, Rewers A, Cherubini V, Estrada S, et al. ISPAD clinical practice consenus guidelines 2022: Diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatr Diabetes 2022;23:835-56. DOI: 10.1111/pedi.13406.
Yati NP, Soesanti F, Tridjaja B. Ketoasidosis diabetik dan edema serebri pada diabetes melitus tipe-1. Jakarta: Ikatan Dokter Anak Indonesia; 2017.
Rewers A. Current concepts and controversies in prevention and treatment of diabetic ketoacidosis in children. Curr Diab Rep. 2012;12(5):524-32. DOI: 10.1007/s11892-012-0307-2.
Pulungan AB, Batubara J, Tridjaja B, Soesanti F, Fadiana G, Annisa D, et al. Profile of diabetic ketoacidosis in children with diabetes mellitus in a tertiary care hospital in Jakarta: A retrospective study. Acta Scient Paediatr. 2019:24-9.
Sjarif D, Nasar S, Devaera Y, Tanjung C. Asuhan nutrisi pediatrik. Jakarta: Ikatan Dokter Anak Indonesia; 2011.
Pulungan BA, Annisa D, Imada S. Diabetes melitus tipe 1-pada anak: Situasi di Indonesia dan Tata Laksana. Sari Pediatri 2019;20(6):392-400.
Wolfsdorf JI, Glaser N, Agus M, Fritsch M, Hanas R, Rewers A, et al. ISPAD clinical practice consesnsus guidelines 2018: Diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Pediatric Diabetes 2018;19:155-77. DOI: 10.1111/pedi.12701.
Douek IF, Gillespie KM, Dix RJ, Bingley PJ, Gale EAM. Three generations of autoimmune diabetes: An extended family study. Diabetologia 2003;46:1313-8. DOI: 10.1007/s00125-003-1186-5.
Lee HS, Hwang JS. Genetic aspects of type 1 diabetes. Ann Pediatr Endocrinol Metab. 2019;24(3):143-8. DOI: 10.6065/apem.2019.24.3.143.
Xu Q, Hui C, Xia L, Chen MW, Deng D. A case of persistent severe abdominal pain caused by type I diabetic ketoacidosis. J Clin Translational Endocrinol. 2021;19(1):100077. DOI: 10.1016/j.jecr.2020.100077.
Dzulfilar. Modul pediatric emergency life support. Unpad Press. 2021.
Kliegman RM, ST Geme JW, Blum NJ, Shah S, Tasker R, Wilson K, et al. Nelson textbook of pediatric. 21th Ed. Vol 2. Philadelphia: Elsevier; 2020 .p. 11844-8.
Rashed A, Kewan H, Donald D, Brian N, Mahesh S. The two bag system for intravenous fluid management of children with diabetic ketoacidosis: Experience from a community-based hospital. Global Pediatric Health 2021;8:1-8. DOI: 10.1177/2333794X21991532.
Veverka M, Marsh K, Norman S, Brock MA, Peng M, Shenk J, et al. A pediatric diabetic ketoacidosis management protocol incorporating a two-bag intravenous fluid system decreases duration of intravenous insulin theraphy. J Pediatr Pharmacol. 2016;21(6):512-7. DOI:10.5863/1551-6776-21.6.512.
Velasco JP, Fogel J, Levine R, Ciminera P, Fagan D, Bargman R. Potential clinical benefits of a two-bag system for fluid management in pediatric intensive care unit patients with diabetic ketoacidosis. Pediatr Endocrinol Diabetes Metab. 2017;23,1:6-13. DOI: 10.18544/PEDM-23.01.0068.
Dhatariya K. Blood ketones: Measurement, interpretation, limitations, and utility in the management of diabetic ketoacidosis. Rev Diabet Stud. 2016;13:217-25. DOI: 10.1900/RDS.2016.13.217.
Pulungan AB, Juwita E, Pudjiadi AH, Rahmayanti S, Tsaniya I. Diabetic ketoacidosis in adolescents and children: A prospective study of blood versus urine ketones in monitoring therapeutic response. Acta Med Indones. 2018;50(1):46-52.
Mackay L, Lyall MJ, Delaney S, Mcknight JA, Strachan MWJ. Are blood ketones a better predictor than urine ketones of acid base balance in diabetic ketoasidosis? Pract Diab Int. 2010;27:9. DOI: https://doi.org/10.1002/pdi.1529
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Astrellatiffany Kuntjoro, Arnold Soetarso
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
