Diabetic ketoacidosis in children – report of three cases
Journal Title: Postępy Nauk Medycznych - Year 2014, Vol 27, Issue 10
Abstract
Diabetic ketoacidosis (DKA) is an acute metabolic complication in patients with type 1 diabetes. It may result from a delayed diagnosis of the disease, or, in patients with type 1 diabetes with bad glycaemic control, from errors of insulin treatment in the case of increased demand for insulin (due to infection, stress, trauma), or from errors in medical treatment, or from neglect in self-treatment. Increasing hyperglycemia leads to diabetic hyperosmolar syndrome. Glycosuria occurs when blood glucose exceeds the renal threshold, leading to osmotic diuresis, which is followed by increased excretion of water and electrolytes. Severe lipolysis leads to increased production of ketone bodies in the liver, causing the progress of ketoacidosis. Its consequences would be hyperventilation, nausea, and vomiting, which intensify dehydration up to oligemic shock and coma. Patients with progressing ketoacidosis should be provided with intensive treatment in a medical centre experienced in the treatment of diabetes as early as possible. Treatment should be in line with recommendations of the international societies of pediatric and adolescent diabetes, pediatric endocrinologists as well as the Polish Diabetes Association. What is crucial along with the detailed treatment protocols is the experience of the doctor and their ability to predict and modify the treatment according to the situation.Based on three examples of treatment of patients with severe DKA in the first day of hospitalization. In this paper we present how to provide the patient with a safe treatment following the recommendations and using the doctor’s experience.
Authors and Affiliations
Grażyna Miszkurka, Beata Pyrżak, Katarzyna Kądziela, Ewelina Witkowska-Sędek
Keywords
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