OBJECTIVE To determine clinical and biochemical factors influencing cerebral edema formation during diabetic ketoacidosis (DKA) in children. STUDY DESIGN We used magnetic resonance diffusion-weighted imaging to quantify edema formation. We measured the apparent diffusion coefficient (ADC) of brain water during and after DKA treatment in 26 children and correlated ADC changes with clinical and...

We undertook the present study to examine the acid-base and electrolyte disturbances in relation to hydration status in patients with diabetic ketoacidosis (DKA). A total of 40 insulin-dependent diabetes mellitus patients (22 male, 18 female), aged 18-61 years with DKA admitted to our hospital during the last 2 years, were studied. The duration of diabetes averaged 9 +/- 2 years. In all cases a...

Type I diabetes mellitus is the most common endocrine-metabolic disorder of childhood and adolescence and diabetic ketoacidosis (DKA) can be life-threatening. The study aims at identifying precipitating factors, states epidemiological features and describes clinical presentations in children with DKA admitted to Pediatric Intensive Care Unit (PICU), King Fahad Hospital, Al-Baha, Saudi Arabia. T...

Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes. The development of metabolic syndrome is widely recognised with the use of atypical antipsychotic agents, and not infrequently DKA has been described with some of these drugs. We describe a complex patient with HIV who presented with severe DKA and prolonged hyperchloraemic acidosis, which we postulate was associated wi...

BACKGROUND AND PURPOSE Subclinical cerebral edema occurs in many, if not most, children with diabetic ketoacidosis (DKA) and may be an indicator of subtle brain injury. Brain ratios of N-acetylaspartate (NAA) to creatine (Cr), measured by proton MR spectroscopy, decrease with neuronal injury or dysfunction. We hypothesized that brain NAA/Cr ratios may be decreased in children in DKA, indicating...

OBJECTIVE Cerebral edema (CE) is a potentially life-threatening complication of diabetic ketoacidosis (DKA) in children. Osmotic fluctuations during DKA treatment have been considered responsible, but recent data instead suggest that cerebral hypoperfusion may be involved and that activation of cerebral ion transporters may occur. Diminished cerebral blood flow (CBF) during DKA, however, has no...

Diabetic Ketoacidosis (DKA) is the most common metabolic complications of diabetes mellitus. In some situations, other acid-base disorders coexist with DKA including metabolic alkalosis. There is several underlying etiology for the DKA with metabolic alkalosis such as extracellular volume loss secondary to vomiting or diuretics, alkali ingestion, and corticosteroid excess. We report herein the ...

Children with diabetic ketoacidosis (DKA) may require central venous catheters (CVC) for fluid resuscitation. CVC-related thrombus has been reported in a variety of conditions but only rarely in association with DKA and never in a child under one. The case of a five week old child with DKA and a CVC-related thrombus is presented.

Methods Data from Auckland children with newly diagnosed T1DM between 1 January 2000 and 31 December 2009 were collected from Starbase, the Starship Children’s Hospital diabetes database. T1DM was confirmed by the presence of glutamic acid decarboxylase and/or tyrosime phosphatise-like protein (IA2) antibodies. DKA was defined by international criteria as venous or capillary pH and bicarbonate ...

The current version of the International Society of Pediatric and Adolescent Diabetes (ISPAD) guidelines for management of diabetic ketoacidosis (DKA) is largely based on the Lawson Wilkins Pediatric Endocrine Society/European Society of Pediatric Endocrinology (LWPES/ESPE) consensus statement on DKA in children and adolescents published in 2004. This article critically reviews and presents the...