2024/12/31 by Khlayfia, Z., Halioui S, Azzabi O +7
#Acidose #Acidosis #Child #Cétose #Diabetesmellitus #Diabètesucré #Enfant #Hyperglycemia #Hyperglycémie #Insulinothérapie #Insulintherapy #ketosis
paper · doi:10.71566/pist-rmp-194745
Introduction:Diabeticketoacidosisis the main acute complication that can occur in patients with type 1 diabetesmellitus. Upto50%youngpeoplealreadyhaveDKAwhentheyarediagnosedwithdiabetesin Tunisia. The objective ofthis studywas to characterize the clinical profile ofthe children population with a diabetic ketoacidosis diagnosis, the therapeutic and prognostic characteristics of diabetic ketoacidosis. Methods:AretrospectivesearchofchildrenwithdiabeticketoacidosiswasperformedinMongiSlimhospital, betweenjanuary2016andjuly2019. Theageofpatientsrangedfrom1to16yearsold. Results:Ourstudyincluded30childrenwithasexratioof1. 1andameanageof5. 8yearsold. TheDKAwasdia- gnosedatonsetoftype1diabetesmellitusin24cases. Familyhistoryofdiabetesin17cases. Thepresentation symptomsofthesepatientsweremainly:polyuriaand polydipsia(N=22),weightloss(N=15),digestivesymptoms (N=14)andbed-wetting(N=8). Clinicalsignsweredehydrationin12cases,deepsighingrespirationin22cases, smellofketonesin20cases,shockin2cases. Allourpatientshadketoneangglucoseinurine. ThemedianpH was7,07,bloodglucosewas25,27mmol/L,correctedserumsodiumlevelwas138,2mmol/L,andcorrected serumpotassiumlevelwas,4mmol/L. Regardingthemanagement,allpatientsreceivedintravenoushydration withanaveragelevelof4,4ml/Kg/hourandintravenousinsulinwithamediandoseof0. 081UI/Kg/hour. Mana- gementwasbasedontheprotocoloftheISPAD(InternationalSocietyforpediatricandadolescentdiabetes)in 21cases. Theaveragedurationofhydrationwas23,8hoursandtheaveragedurationofhospitalisationwas9,8 days. Hypoglycemiawas noticed in 8 cases duringtreatment. Conclusion:DiabeticketoacidosisisthemaincauseofmorbidityandmortalityinchildrenwithT1DM. Preventionofdiabeticketoacidosisatdiagnosiswill require acombination ofrepeated direct physician outreach combinedwith more regularawareness campaignfocusingonthesekeydiagnosticfeatures oftype 1 diabetes mellitus.