Abstract
Diabetic ketoacidosis is the most common endocrine emergency in children and frequently it is the initial presentation of insulin dependent diabetes mellitus. Despite sophisticated technology and our improved understanding of the pathophysiology of this disease, the mortality from intracranial complications remains constant over the past two decades. Several management protocols are used all over the world but the recent trend in opinion seems to be one of the slower rates of initial hydration aimed at matching the osmolarity of the infusion solutions with the patient's serum osmolarity. It remains to be seen if widespread use of this rehydration strategy will improve morbidity in the future. A protocol for managing diabetic ketoacidosis is suggested.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Travis LB, Kalia A. Diabetic ketoacidosis. In: Travis LB, Brouhard BH, Schreiner BJ ed.Diabetes Mellitus in Children and Adolescents. Philadelphia, Pa.: WB Saunders Co. 1987; 147–168.
Rosenbloom AL, Schatz DA. Diabetic ketoacidosis in childhood.Pediatr Ann 1994; 23: 284–288.
Fulop M, Tannenbaum H, Dreyer N. Ketotic hyperosmolar coma.Lancet 1973; 2: 635–639.
Kecskes SA. Diabetic ketoacidosis.Pediatr Clin North Am 1993; 40: 355–363.
Duck SC, Wyatt DT. Factors associated with brain herniation in the treatment of diabetic ketoacidosis.J Pediatr 1988; 113: 10–14.
Harris GD, Fiordalisis I, Finberg L. Safe management of diabetic ketoacidemia.J Pediatr 1988; 113: 65–68.
Mel JM, Werther GA. Incidence and outcome of diabetic cerebral edema in childhood; are there predictors?J Pediatr Child Health 1995; 31: 17–20.
Musey VC, Lee JK, Crawford Ret al. Diabetes in urabn African-Americans. I. Cessation of insulin therapy is the major precipitating cause of diabetic ketoacidosis.Diabetes Care 1995; 18: 483–489.
Elamin A, Kheir KM, Tuvemo T. Diabetic ketoacidosis in children in Khartoum city, Sudan.East Afr Med J 1994; 71: 102–105.
Harris GD, Firordalisi I. Physiologic management of diabetic ketoacidemia. A 5-year prospective pediatric experience in 232 episodes.Arch Pediatr Adolesc Med 1994; 148: 1046–1052.
Sperling MA. Diabetic ketoacidosis.Pediatr Clin North Am 1984; 31: 591–610.
Roberts KB. Fluid management of children who have diabetic ketoacidosis.Pediatr Rev 1995; 16: 304–305.
Edge JA, Dunger DB. Variations in the management of diabetic ketoacidosis in children.Diabet Med 1994; 11: 984–986.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Krishna, J. Recent advances in management of diabetic ketoacidosis. Indian J Pediatr 64, 27–32 (1997). https://doi.org/10.1007/BF02795773
Issue Date:
DOI: https://doi.org/10.1007/BF02795773