Diabetic ketoacidosis or DKA is the leading cause of morbidity and mortality in children with Type 1 DM. DKA is characterized by hyperglycemia, metabolic acidosis, and ketosis and needs an immediate attention and management in the ICU. This article outlines the management approach for DKA and an overview of its complications. Diabetic ketoacidosis has a case-fatality rate ranging from 0.15 to 0.31%.
The diagnosis of DKA is confirmed when there is: Hyperglycemia, with BSL >200 mg/dL (11 mmol/L), Metabolic acidosis with a venous pH <7.3 or a plasma bicarbonate <15 mEq/L (15 mmol/L), Ketosis, with BOHB concentrations ≥3 mmol/L (31 mg/dL). The diagnosis of DKA should be carefully evaluated. In children with severe hyperglycemia (BSL >600 to 2500 mg/dL) without any significant metabolic acidosis or ketosis, the diagnosis deviates to hyperglycemia hyperosmolar state (HHS) rather than the…
