Epidemiological, clinical and laboratory findings of children fewer than 15 years with diabetic ketoacidosis admitted at San Vicente Fundación Hospital in Medellín, Colombia, between January 2001 and December 2010

Abstract

Introduction: 
Diabetic ketoacidosis (DKA) is the most important acute complication in children with diabetes mellitus. There are several publications regarding the characteristics of children with DKA admitted to hospital care in developed countries, however, in our population there is no information concerning the characteristics of these children. Our aim is to determinate these characteristics.

Methods:

Retrospective study of DKA events in children fewer than 15 years admitted to HUSVF between 2001 and 2010. The information was collected from medical records and characteristics are depicted by descriptive statistics.

Results:

We included 98 events of DKA in 77 patients, 64.3% were women, uninsured 23.5%.  DKA was the debut of the disease in 53.1%, the average age was 8.7 years (DE 4.35).  Patients with known diagnosis didn’t have treatment adherence in 57%, 42,8 % of patients had urinary tract, gastrointestinal, respiratory or another febrile illness at admission. The time between the onset of symptoms and admission was 109 hours (1-720 hours). Ketoacidosis was mild in 29.5%, moderate in 28.7% and severe in 41.8%. The pH at admission was 7,12 (SD 0,12). It took 12.6 hours (SD 8,98) to reach pH 7,30. 14.4% showed hypokalemia, hyponatremia 28.6%, 28.6% hypoglycemia, 5% had cerebral edema and mortality was 2%.

Conclusions:

Clinical and laboratory characteristics of our population are similar to those reported in other studies. Lack of adherence can be an important and preventable cause of decompensation.