Clinical presentation and Outcomes of Diabetic ketoacidosis in Children: A Retrospective study at a Tertiary Care Hospital

Abstract

Objective: To assess the clinical presentation and outcomes of Diabetic Ketoacidosis in Pakistani children with type 1 diabetes.

Study design: A Retrospective study.

Duration of place of study.  Department of Pediatric Saidu teaching hospital swat from Jan, 2020 to 31st Dec 2023

Methods: This retrospective analysis was carried out in previous 3 years from 1^st Jan, 2020 to 31^st Dec 2023 on 79 cases. Record of patients fulfilling the inclusion criteria which according to the international society of pediatrics and adolescent diabetes, DKA is defined by the presence of all of the following, RBS >200, PH <7.3, and HCO3 <15 meq/L. Clinical features of all included patients were recorded on predesigned proforma. Complications and mortality were compared across DKA severities using statistical tests with a significance level set at p < 0.05.

Results: The mean age was 9.27 ± 2.95, and 51 (64.56%) were females. The most common clinical feature observed in the study participants was abdominal pain, reported by 51 (64.56%) individuals. Following closely, vomiting was observed in 43 (54.43%), respiratory distress in 45 (56.96%), and polyuria in 41 (51.90%). Other features, such as fever (n=12, 15.19%), shock (n=11, 13.92%), and enuresis (n=17, 21.52%), were reported with lower frequency. Mortality was found to be 10.13% and limited to severe DKA cases.

Conclusion: The most common features of children with DKA are abdominal pain, respiratory distress, and polyuria-polydipsia. Severe DKA cases have a high rate of mortality.