Emergency Department Presentations of Diabetic Ketoacidosis in a Large Cohort of Children
Authors' conclusion
Greater efforts are needed to identify the children with diabetes early and to prevent recurrent DKA, particularly among children in low-SES groups. Young children with DKA may need more intensive monitoring due to higher risk of cerebral injury.
Study context
- Population
- Children <18 years with diabetic ketoacidosis (DKA) (glucose > 300 mg/dL, serum pH < 7.25, or serum bicarbonate <15 mEq/L) at 12 centers of the Pediatric Emergency Care Applied Research Network (PECARN) FLUID Trial, including non-enrolled presenting children
- Participants
- 1,553 children1,679 DKA episodes
- Exposure
- Newly vs previously diagnosed diabetes; age groups; Socioeconomic status (SES)
- Outcome
- DKA episodes: new-onset diabetes and severity
Methodological detailssecondary analysis of the PECARN FLUID Trial, multicentre, 12 centers
- Secondary analysis of the PECARN FLUID Trial
- Multicentre
- 12 centers
Main finding
As reported in the abstract
Episodes in children with newly diagnosed diabetes
799
47.5%
Severe DKA (pH < 7.1)
396
23.6%
Observational data: associations, not effects.
Further findings
Newly diagnosed children <6 years
- Not more likely to have severe DKA by pH, but more severe hypocarbia and higher blood urea nitrogen
Lower SES (family income, maternal education)
- Associated with more severe DKA in new-onset children and recurrent DKA in previously diagnosed children
Original publication
Emergency Department Presentations of Diabetic Ketoacidosis in a Large Cohort of Children. Pediatr Diabetes. Published 20 September 2023. doi:10.
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