Abstract
In youth with T1D, the majority of diabetic ketoacidosis (DKA) events could be prevented by an overall improvement of metabolic control, reasons underlying omission of insulin, and a good understanding of early and appropriate implementation of sick day management. Consequently, the overarching aim of this chapter is to review in detail how to manage youth with T1D who are in the early stages of DKA. An important feature of this review is the provision of a sick day management flow sheet for patients using insulin pumps and a separate flow sheet for youth receiving insulin injections. We have also demonstrated that failure to recognize developing DKA in patients receiving adjunctive treatment with a SGLT2 inhibitor is due to delayed increases in plasma glucose rather than more rapid increases in β-hydroxybutyrate levels.
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References
Cengiz E, Xing D, Wong J, Beck RW, Haymond MW, Miller KM, Rewers A, Seiple DL, Shanmugham S, Tamborlane WV, Willi SM. Wolfsdorf JI for the T1D Exchange Clinic Network. Risk of severe hypoglycemia and diabetic ketoacidosis and associated risk factors among youth with type 1 diabetes in the T1D exchange registry cohort. Pediatr Diabetes. 2013;14:447–54.
Maahs DM, Hermann JM, Holman N, Foster N, Kapellen T, Allgrove J, Schatz DA, Hofer SE, Campbell F, Steigleder-Schweiger C, Beck RW, Warner JT, Holl RW. On behalf of the National Paediatric Diabetes Audit & the Royal College of Paediatrics & Child Health (UK), the DPV initiative (Germany and Austria), and the T1D Exchange Clinic Network (US). Rates of diabetic ketoacidosis: international comparison with 49,859 pediatric patients from England, Wales, the United States of America, Austria and Germany. Diabetes Care. 2015;38:1876–82.
Wolfsdorf JI, Glaser N, Agus M, Fritsch M, Hanas R, Rewers A, Sperling MA, Codner E. ISPAD clinical practice consensus guidelines 2018: diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Pediatr Diabetes. 2018;19:155–77.
Laffel LM, Limbert C, Phelan H, Virmani A, Wood J, Hofer SE. ISPAD clinical practice consensus guidelines 2018: sick day management in children and adolescents with diabetes. Pediatr Diabetes. 2018;19:193–204.
Jeffries CA, Nakhla M, Derraik JGB, Gunn AJ, Daneman D, Cutfield WS. Preventing diabetic ketoacidosis. Pediatr Clin N Am. 2015;62:857–71.
Vitale RJ, Card C, Lichtman JH, Weyman K, Michaud C, Sikes K, Tamborlane WV, Weinzimer SA. Effectiveness of a diabetic ketoacidosis prevention intervention in children with type 1 diabetes. SAGE Open Nurs. 2018;4:1–6.
Patel N, Van Name M, Carria L, Cengiz E, Weinzimer S, Tamborlane WV, Sherr J. Altered patterns of early metabolic decompensation in type 1 diabetes during treatment with a SGLT-2 inhibitor: an insulin pump suspension study. Diabetes Technol Ther. 2017;19:618–22.
Siebel S, Galderisi A, Patel NS, Carria LR, Tamborlane WV, Sherr JL. Reversal of ketosis in type 1 diabetes is not adversely affected by SGLT2 inhibitor therapy. Diabetes Technol Ther. 2019;21:101–4.
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Mencher, S., Choksi, I., Patel, A. (2021). Sick Day Management. In: Tamborlane, W.V. (eds) Diabetes in Children and Adolescents. Contemporary Endocrinology. Humana, Cham. https://doi.org/10.1007/978-3-030-64133-7_11
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DOI: https://doi.org/10.1007/978-3-030-64133-7_11
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