J Korean Diabetes > Volume 18(3); 2017 > Article
The Journal of Korean Diabetes 2017;18(3):193-204.
DOI: https://doi.org/10.4093/jkd.2017.18.3.193    Published online October 12, 2017.
단일기관에서 경험한 소아 당뇨 케토산증의 고찰
최이호, 김민선, 황평한, 이대열
Clinical and Laboratory Characteristics of Pediatric Diabetic Ketoacidosis: A Single-Center Study.
Iee Ho Choi, Min Sun Kim, Pyoung Han Hwang, Dae Yeol Lee
1Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea. children@jbnu.ac.kr
2Research Institute of Clinical Medicine of Chonbuk National University–Biomedical Institute of Chonbuk National University Hospital, Jeonju, Korea.
Abstract
BACKGROUND
Diabetic ketoacidosis (DKA) is an acute complication of pediatric type 1 diabetes mellitus (T1DM). We aimed to determine the risk factors and clinical characteristics of children and adolescents with DKA. METHODS: We retrospectively evaluated 59 episodes of DKA in 43 patients who were hospitalized for DKA between January 2006 and December 2015. DKA was classified as mild, moderate, or severe, according to patient history of DKA. The clinical and laboratory characteristics of these subgroups were compared. RESULTS: The average patient age was 11.98 ± 4.40 years (range, 1.3~17.9 years). Moderate episodes were the most common, with 21 episodes (35.6%), followed by 19 severe (32.2%) and 19 mild episodes (32.2%). Significant differences were observed between the subgroups regarding their characteristics of aggravated. Severe DKA episodes were more often observed during the winter season. Recurrent DKA cases were determined in 31 episodes (52.5%) who were significantly older, had higher body mass index, and lower serum C-peptide levels than the newly diagnosed DKA group. Female patients experienced severe and moderate cases more frequently (P = 0.041), which included two deaths. Only blood glucose levels were significantly higher in these fatal cases (P = 0.022). CONCLUSION: Even among the patients who had previously experienced DKA and older children with low serum C-peptide levels, there was no reduction in the severity of DKA. We recommend that patients with DKA be carefully treated and continuously informed regarding the importance of maintaining proper blood glucose levels, regardless of their previous history of DKA, age, or regularity of insulin therapy.
Key Words: Child, Diabetic ketoacidosis, Diabetes mellitus, Type 1
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