a Prevalence and associated factors of diabetic ketoacidosis among pediatrics: Hospital Based Cross Sectional Study in Hawassa University, Comprehensive specialized Hospital
- Articles
- Submited: October 15, 2019
-
Published: June 26, 2020
Abstract
Diabetic ketoacidosis is a medical emergency that requires prompt hospital admission and treatment. It contributes significantly to morbidity and mortality in children with type-1 diabetes mellitus. DKA is a result of absolute or relative shortage of insulin deficiency, resulted in hyperglycemia, ketonemia, acidemia, and systemic inflammation.
Objective: To study the prevalence of diabetic ketoacidosis and associated factors among pediatric diabetic age group in Hawassa University teaching hospital from September 2014 to August 2019 G.C.
Methodology: The research area is in a pediatric clinic, Hawassa University teaching hospital. This study is a retrospective cross-sectional study of 150 cases had diabetes mellitus. Data were collected from patient records by trained Data collectors. Data intended for our study that consists of the patient's history, physical examination, progress notes, treatment results, and a summary of deaths from September 2014 until August 2019.
Result: DKA prevalence is 72 percent. It was common among the age group 10 to 14 years, which is 28.7 per cent. The majority of them, 98.7 percent are type 1 DM. Of all patients with DKA 50 (46.2%) were on drugs, of which 48 (96%) had used insulin and 2 (4%) were on oral hypoglycemic agents.
Conclusion: Diabetic ketoacidosis was high among patients with Type-1 diabetes. Most patients with DKA presented with symptoms of poly (polyphagia, polydipsia, and polyuria).
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References
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28. Wolfsdorf J, Glaser N, Sperling MA. Diabetic ketoacidosis in infants, children, and adolescents: a consensus statement from the American Diabetes Association. Diabetes care. 2006 May 1;29(5):1150-9..
29. Daneman D, Nakhla MM. Diabetic ketoacidosis in children and youth. Diabetes Management. 2012;2(6):571-8.
30. Glaser, N., Barnett, P., McCaslin, I., Nelson, D., Trainor, J., Louie, J., Kaufman, F., Quayle, K., Roback, M., Malley, R. and Kuppermann, N., 2001. Risk factors for cerebral edema in children with diabetic ketoacidosis. New England Journal of Medicine, 344(4), pp.264-269.
31. Edge JA. Cerebral oedema during treatment of diabetic ketoacidosis: are we any nearer finding a cause?. Diabetes/metabolism research and reviews. 2000 Sep;16(5):316-24.]
32. Acid–Base Problems in Diabetic Ketoacidosis Kamel S. Kamel, M.D., and Mitchell L. Halperin, M.D
33. Hadgu, F.B., Sibhat, G.G. and Gebretsadik, L.G., 2019. Diabetic ketoacidosis in children and adolescents with newly diagnosed type 1 diabetes in Tigray, Ethiopia: retrospective observational study. Pediatric health, medicine and therapeutics, 10, p.49. ?iri? V. SEVERE KETOACIDOSIS IN A NEWLY DIAGNOSED PATIENT WITH TYPE 2 DIABETES AND METABOLIC SYNDROME. Acta Medica Medianae. 2019; 58(1):82-6.
34. Usher-Smith J, Thompson M, Ercole A, Walter F. Variation between countries in the frequency of diabetic ketoacidosis at first presentation of type 1 diabetes in children: a systematic review. Diabetologia. 2012;55(11):2878-94
35. Trends in the Prevalence of Ketoacidosis at Diabetes Diagnosis: The SEARCH for Diabetes in Youth Study
36. Clinical Characteristics of Diabetic Ketoacidosis in Children with Newly Diagnosed Type 1 Diabetes in Addis Ababa, Ethiopia: A Cross-Sectional Study
37. Atkilt, H.S., Turago, M.G. and Tegegne, B.S., 2017. Clinical characteristics of diabetic ketoacidosis in children with newly diagnosed Type 1 diabetes in Addis Ababa, Ethiopia: a cross-sectional Study. PloS one, 12(1), p.e0169666.
38. Patterson, C., Guariguata, L., Dahlquist, G., Soltész, G., Ogle, G. and Silink, M., 2014. Diabetes in the young–a global view and worldwide estimates of numbers of children with type 1 diabetes. Diabetes research and clinical practice, 103(2), pp.161-175.
2. Charfen, M.A. and Fernández-Frackelton, M., 2005. Diabetic ketoacidosis. Emergency medicine clinics of North America, 23(3), pp.609-28.
3. Phillips C, Sinha A. Successful management of diabetic ketoacidosis: an innovative protocol. Practical Diabetes. 2018 Mar;35(2):51-4.
4. Umpierrez GE, Khajavi M, Kitabchi AE. diabetic ketoacidosis and hyperglycemic hyperosmolar nonketotic syndrome. The American journal of the medical sciences. 1996;311(5):225-33.
5. Association AD. Hyperglycemic crises in patients with diabetes mellitus. Diabetes Care. 2001;24(11):1988-96.
6. Gosmanov AR, Gosmanova EO, Kitabchi AE. Hyperglycemic crises: diabetic ketoacidosis (DKA), and hyperglycemic hyperosmolar state (HHS). Endotext [Internet]: MDText. com, Inc.; 2018
7. Mallare JT, Cordice CC, Ryan BA, Carey DE, Kreitzer PM, Frank GR. Identifying risk factors for the development of diabetic ketoacidosis in new onset type 1 diabetes mellitus. Clinical pediatrics. 2003 Sep;42(7):591-7.
8. Usher-Smith JA, Thompson MJ, Sharp SJ, Walter FM. Factors associated with the presence of diabetic ketoacidosis at diagnosis of diabetes in children and young adults: a systematic review. Bmj. 2011;343:d4092.
9. Nyenwe EA, Kitabchi AE. The evolution of diabetic ketoacidosis: an update of its etiology, pathogenesis and management. Metabolism. 2016 Apr 1;65(4):507-21.
10. Lupsa, B.C. and Inzucchi, S.E., 2014. Diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome. In Endocrine Emergencies (pp. 15-31). Humana Press, Totowa, NJ.
11. Umpierrez GE, Khajavi M, Kitabchi AE. diabetic ketoacidosis and hyperglycemic hyperosmolar nonketotic syndrome. The American journal of the medical sciences. 1996 May;311(5):225-33.
12. Wolfsdorf JI, Glaser N, Agus M, Fritsch M, Hanas R, Rewers A, Sperling MA, Codner E. Diabetic ketoacidosis and hyperglycemic hyperosmolar state: a consensus statement from the International Society for Pediatric and Adolescent Diabetes. Pediatr Diabetes. 2018;19(Suppl 27):155-77.
13. Wolfsdorf J, Glaser N, Sperling MA. Diabetic ketoacidosis in infants, children, and adolescents: a consensus statement from the American Diabetes Association. Diabetes care. 2006 May 1;29(5):1150-9.
14. Hillman K. Fluid resuscitation in diabetic emergencies—a reappraisal. Intensive care medicine. 1987;13(1):4-8.
15. Corsino L, Dhatariya K, Umpierrez G. Management of diabetes and hyperglycemia in hospitalized patients. InEndotext [Internet] 2017 Oct 1. MDText. com, Inc..
16. Chaithongdi, N., Subauste, J.S., Koch, C.A. and Geraci, S.A., 2011. Diagnosis and management of hyperglycemic emergencies. Hormones, 10(4), pp.250-260.
17. Van Ness-Otunnu, R., & Hack, J. B. (2013). Hyperglycemic Crisis. The Journal of Emergency Medicine, 45(5), 797–805.doi:10.1016/j.jemermed.2013.03.040
18. Sherry, N. A., & Levitsky, L. L. (2008). Management of Diabetic Ketoacidosis in Children and Adolescents. Pediatric Drugs, 10(4), 209–215. doi:10.2165/00148581-200810040-00002
19. Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes care. 2009;32(7):1335-43.
20. Predictive factors of ketoacidosis in type 1 diabetes mellitus Listianingrum, Suryono Yudha Patria, Tunjung Wibowo
21. Szypowska, A., & Skórka, A. (2010). The risk factors of ketoacidosis in children with newly diagnosed type 1 diabetes mellitus. Pediatric Diabetes, 12(4pt1), 302–306.doi:10.1111/j.1399-5448.2010.00689.x
22. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes care. 2004;27:S5.
23. Fayfman M, Pasquel FJ, Umpierrez GE. Management of hyperglycemic crises: diabetic ketoacidosis and hyperglycemic hyperosmolar state. Medical Clinics. 2017 May 1;101(3):587-606.
24. Gosmanov AR, Gosmanova EO, Kitabchi AE. Hyperglycemic crises: diabetic ketoacidosis (DKA), and hyperglycemic hyperosmolar state (HHS). InEndotext [Internet] 2018 May 17. MDText. com, Inc..
25. American Diabetes Association. Hyperglycemic crises in patients with diabetes mellitus. Diabetes care. 2002 Jan 1;25(suppl 1):s100-8.
26. (Pastakia SD, Pekny CR, Manyara SM, Fischer L. Diabetes in sub-Saharan Africa–from policy to practice to progress: targeting the existing gaps for future care for diabetes. Diabetes, metabolic syndrome and obesity: targets and therapy. 2017;10:247.)
27. Atun R, Davies JI, Gale EA, Bärnighausen T, Beran D, Kengne AP, Levitt NS, Mangugu FW, Nyirenda MJ, Ogle GD, Ramaiya K. Diabetes in sub-Saharan Africa: from clinical care to health policy. The lancet Diabetes & endocrinology. 2017 Aug 1;5(8):622-67.
28. Wolfsdorf J, Glaser N, Sperling MA. Diabetic ketoacidosis in infants, children, and adolescents: a consensus statement from the American Diabetes Association. Diabetes care. 2006 May 1;29(5):1150-9..
29. Daneman D, Nakhla MM. Diabetic ketoacidosis in children and youth. Diabetes Management. 2012;2(6):571-8.
30. Glaser, N., Barnett, P., McCaslin, I., Nelson, D., Trainor, J., Louie, J., Kaufman, F., Quayle, K., Roback, M., Malley, R. and Kuppermann, N., 2001. Risk factors for cerebral edema in children with diabetic ketoacidosis. New England Journal of Medicine, 344(4), pp.264-269.
31. Edge JA. Cerebral oedema during treatment of diabetic ketoacidosis: are we any nearer finding a cause?. Diabetes/metabolism research and reviews. 2000 Sep;16(5):316-24.]
32. Acid–Base Problems in Diabetic Ketoacidosis Kamel S. Kamel, M.D., and Mitchell L. Halperin, M.D
33. Hadgu, F.B., Sibhat, G.G. and Gebretsadik, L.G., 2019. Diabetic ketoacidosis in children and adolescents with newly diagnosed type 1 diabetes in Tigray, Ethiopia: retrospective observational study. Pediatric health, medicine and therapeutics, 10, p.49. ?iri? V. SEVERE KETOACIDOSIS IN A NEWLY DIAGNOSED PATIENT WITH TYPE 2 DIABETES AND METABOLIC SYNDROME. Acta Medica Medianae. 2019; 58(1):82-6.
34. Usher-Smith J, Thompson M, Ercole A, Walter F. Variation between countries in the frequency of diabetic ketoacidosis at first presentation of type 1 diabetes in children: a systematic review. Diabetologia. 2012;55(11):2878-94
35. Trends in the Prevalence of Ketoacidosis at Diabetes Diagnosis: The SEARCH for Diabetes in Youth Study
36. Clinical Characteristics of Diabetic Ketoacidosis in Children with Newly Diagnosed Type 1 Diabetes in Addis Ababa, Ethiopia: A Cross-Sectional Study
37. Atkilt, H.S., Turago, M.G. and Tegegne, B.S., 2017. Clinical characteristics of diabetic ketoacidosis in children with newly diagnosed Type 1 diabetes in Addis Ababa, Ethiopia: a cross-sectional Study. PloS one, 12(1), p.e0169666.
38. Patterson, C., Guariguata, L., Dahlquist, G., Soltész, G., Ogle, G. and Silink, M., 2014. Diabetes in the young–a global view and worldwide estimates of numbers of children with type 1 diabetes. Diabetes research and clinical practice, 103(2), pp.161-175.
How to Cite
mengistu, kurabachew. (2020). a Prevalence and associated factors of diabetic ketoacidosis among pediatrics: Hospital Based Cross Sectional Study in Hawassa University, Comprehensive specialized Hospital . Ethiopian Medical Journal, 58(03). Retrieved from https://emjema.org/index.php/EMJ/article/view/1382
