A Nested Case–Control Study of Adverse Outcomes in Children With Diabetic Ketoacidosis
Authors' conclusion
Hypernatremia is more likely to be present at admission and to persist over the first 24 hours of treatment in children with DKA-HHS who have adverse outcomes. This is not associated with differences in management.
Study context
- Population
- Children admitted for diabetic ketoacidosis (DKA) or hyperglycemic-hyperosmolar syndrome (HHS), 2010–2023; 4565 admissions, 109 with adverse outcomes84 cases, equal number of matched controls
- Comparison
- Children with DKA-HHS with adverse outcomes vs without
- Casesn = 84
- Outcome
- Differences in management and clinical characteristics between cases and controls
Methodological detailsmatched on composite risk score
- Matched on composite risk score
Performance
As reported in the abstract
- No difference in risk score, initial pH, maximum blood glucose or proportion with T2D
- Cases had more new-onset diabetes and higher initial serum sodium and blood urea nitrogen
- Cases had slower resolution of hyperglycemia, acidosis and hypernatremia
- No difference in total fluid bolus volumes, total fluid volumes or urine output at 12 and 24 hours
- Total insulin did not differ after 12 hours; cases more likely to still require IV insulin at 24 hours
Original publication
A Nested Case–Control Study of Adverse Outcomes in Children With Diabetic Ketoacidosis. J Clin Endocrinol Metab. Published 6 December 2024. doi:10.
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