Diabetic ketoacidosis in Children (DKA in Children)
Diabetic ketoacidosis is the most common complication seen in patients with type 1 diabetes mellitus (DM). About 30% of new onset type 1 DM present as DKA. This is generally because parents attribute the symptoms in their children to various common conditions. By the time they realize it is very different, symptoms can be severe. This delay is very common in children less than 2 years of age and lower socio-economic status.
Children in DKA often present with abdominal pain, vomiting, losing weight, frequent urination and frequent desire to eat and drink. Frequent urination, loss of weight and excessive appetite often present 2 weeks or more before presenting illness in a patient with new onset type 1 DM. Abdominal pain and vomiting in a known diabetic patients should raise the concern for DKA and seek medical advice.
Fearsome complication of DKA in children is Cerebral Edema. It used to cause significant disability and some instances death in children 20 years ago. With the newer mode of treatment, less than 1% of children lose their life because of cerebral edema. This is very avoidable by seeking medical care early and starting the treatment early. Even though cerebral edema becomes obvious in the hospital while receiving treatment, the process starts very early.
If the initial presentation is severe, the likelihood of developing cerebral edema is greater. This article is written to make sure parents can recognize DKA early, especially in a new onset diabetic. The younger the child, the more likely they are to develop cerebral edema and its consequence.