Clinical Characteristics and Outcomes of Diabetic Ketoacidosis in School-Age Children: A Single-Center Analysis of 60 Cases
Abstract
Background: Diabetic ketoacidosis (DKA) remains a significant complication in pediatric diabetes, yet specific data focusing on school-age children is limited. This study analyzed the clinical characteristics and outcomes of DKA in this distinct age group to enhance our understanding and improve management strategies.
Methods: We conducted a retrospective analysis of 60 cases of DKA in children aged 6-12 years admitted to our tertiary care center between January 2022 and December 2023. Clinical characteristics, laboratory parameters, treatment outcomes, and complications were evaluated. DKA severity was classified according to venous pH values, and outcomes were analyzed using standardized protocols based on ISPAD guidelines.
Results: The study included 60 patients (mean age 9.3 ± 2.1 years, 56.7% female), with 31.7% being newly diagnosed cases. DKA severity distribution showed 36.7% mild, 41.7% moderate, and 21.6% severe cases. The median time to DKA resolution was 16.8 hours (IQR: 12.4-22.6), with a mean hospital stay of 3.2 ± 1.4 days. Complications occurred in 13.3% of cases, including cerebral edema (3.3%), hypokalemia (6.7%), and hypoglycemia (3.3%). Among established diabetes cases, insulin omission (46.3%) and technical insulin pump issues (14.6%) were the primary precipitating factors. Multivariate analysis identified severe initial acidosis (pH <7.1) as a significant predictor of prolonged DKA resolution (adjusted OR 2.9, 95% CI 1.3-6.5).
Conclusions: Our findings reveal distinct patterns of DKA presentation and outcomes in school-age children, with notably lower rates of severe cases and complications compared to general pediatric populations. The emergence of insulin pump-related issues as a significant precipitating factor highlights the need for enhanced technical support and education programs. These results support the development of age-specific management protocols and preventive strategies for DKA in school-age children.
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References
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