Dicle universty and children's endocrine clinic of pediatrics emergency retrospective evaluation of patients presenting with in diabetic ketoacidosis

Diabetic ketoacidosis is a life-threatening acute metabolic disorder that is characterized by absolute or relative deficiency of circulating insulin and increased levels of counter regulatory hormones in the circulation. The aim of the study is to investigate effect of acidosis severity of patients, who are followed because of DKA, on the clinical and laboratory parameters, and to create an awareness in regard to early and careful diagnosis and treatment of type I diabetes may reduce morbidity and mortality as well as complications associated with DKA. Files of 70 hospitalized children patients with DKA diagnosis were examined retrospectively and data of patients were recorded in detail in Dicle University, Faculty of Medicine on January 2007- April 2013. The patients, who were in blood glucose values> 250 mg / dL, pH<7.35 or HCO3<15 mmol / L, and positive for urine ketones, were evaluated in the study. Age, sex, application season, complaints, dehydration degree, GKS, brain oedema and acidosis levels of patients were assessed. Moreover, blood gases, biochemistry, total blood count, insulin, hbA1c,C-peptid levels and urine ketone were examined for laboratory results. Mean age of patients was 10.3 ± 3.5 (years), 65.7% of patients were female and 55% of patients were 11-18 old age. Newly diagnosed type 1 DM was the first and infections were second in DKA etiology. The patients mostly complained by nausea and vomiting. 25.7% of patients were in severe acidosis. 85.7% of those had a second degree of dehydration. Metabolic controls of 75.7% of patients with approximately average blood sugar level 518.6 ± 148.4 mg /dL were bad. Brain oedema was seen in 5 (7.1%) patients and one patient was died because of brain oedema. The mortality rate: 1.4% (n = 1). Close following of patients in terms of brain oedema symptoms during treatment and necessary intervention at the appropriate time would be life saver. Individual treatment and care should be planned based on periodical features of children and adolescents. Enhancement of DKA information of first level practitioners in order to diminish mortality and morbidity of DKA, and appropriate and dynamic treatment applications of child practitioners for patients in strict following rules after correct and rapid diagnosis will decrease both early and late complications. Keywords: Children, Diabetes, Ketoacidosis, Complications