Clinical Profile of Pediatric Diabetic Ketoacidosis in Karbala City, IRAQ

Abstract

BACKGROUND Diabetic ketoacidosis (DKA) is the most severe diabetic emergency and is still associated with a significant mortality (∼1–2% in western countries, but particularly in developing countries where mortality is substantially higher). It is a state of severe uncontrolled diabetes caused by insulin deficiency and requires urgent treatment with insulin and fluids to prevent death. DKA occurs more commonly in younger people, but the mortality is higher in the elderly. Approximately 25% of new patients with diabetes will present with DKA. In children with established diabetes the risk of DKA is increased in those with poor metabolic control and previous episodes of DKA, adolescent girls, children with psychiatric disorders including eating disorders and those with psychosocial difficulties. The majority of the remainder are due to inadequate insulin during intercurrent illness. THE AIM OF STUDY: To evaluate the clinical profile of pediatric DKA in Karbala city /Iraq. PATIENTS AND METHODS: This is a retrospective study involved diabetic patients admitted to Karbala paediatric teaching hospital and al Hindyia general hospital from the 1st of January to the 31th of December 2014 who had been admitted as a case of diabetic ketoacidosis. A total no. of 68 patients included in this study, they are classified according to the age, gender, severity of DKA, the precipitating factor of DKA and according to the residency. RESULTS: From the 68 patients whom included in this study, there were 16 males and 52 females with male: female ratio of 0.3: 1. The patients divided according to the age into 3 groups (1-5, 6-10 & 11-15 years). The factors which precipitate DKA were: 18 patients presented in state of DKA as first presentation of IDDM, infections were the precipitating factor in 31 patients and the other 24 patients were due to omission of insulin. The patients classified according to the severity of DKA in regard to the age groups and gender and the results show as that 18   patients were presented in mild DKA, 24 patients in state of moderate DKA and the other 26 patients were presented in state of severe DKA. CONCLUSION: DKA is an acute metabolic complication of IDDM that can be life-threatening. Although the incidence of DKA is more common in girls, the severity of the condition is more in boys. 

Keywords: pediatric, DKA, IDDM, Karbala.