Thiamine level and possible metabolic effects in diabetic ketoasidosis

Thiamine is an important cofactor in glucose metabolism. The aim of this study is to explain the level of thiamine in children presenting with diabetic ketoacidosis (DKA), the effect of possible thiamine deficiency on the duration of diabetic ketoacidosis, the patient's clinic, and the metabolic effects that occur during diabetic ketoacidosis. 49 children, 32 of whom were girls (65.3%), who were diagnosed with DKA between December 2018 and March 2020, were included in the study. Serum lactate, pyruvate and thiamine levels were measured when DKA treatment was initiated and treatment was discontinued and subcutaneous insulin therapy was started. GCS (glascow coma scale), blood gas, MCV, HbA1c levels were evaluated at admission. The mean age of the patients was 11.1 ± 5.5 (min = 23 months-max = 17 years) years. While 30 (%61.2) of the patients were newly diagnosed with type 1 diabetes, 19 (%38.8) were previously diagnosed. The mean duration of the patients with diabetes was 4.5 ± 2.7 years. When the DKA degree of the patients was evaluated, 6 (%12.2) were mild, 13 (%26.5) were moderate and 30 (%61.2) were severe. While the thiamine level of the patients was normal before DKA treatment, it was found to be significantly lower after the treatment (p <0.001). It was observed that there was a significant negative correlation between pre-treatment thiamine level and pyruvate / lactate ratio before and after treatment (p values 0.014 and 0.001, respectively). There was a significant negative correlation between post-treatment thiamine and post-treatment pyruvate / lactate ratio. As a result, no relationship was found between the duration of DKA and serum thiamine level in children with DKA with normal thiamine level at admission. In addition, the effect of thiaime on the pyruvate / lactate ratio was once again demonstrated. Keywords: Diabetic Ketoacidosis, Thiamine, Child