Diabetic ketoacidosis in childhood remains a serious and life-threatening condition despite improvements in the management of the fluid and electrolyte disturbances over the last few decades. Although increased awareness among primary health care teams should have led to earlier diagnosis, around a quarter of children still present in diabetic ketoacidosis at the diagnosis of type 1 diabetes; the proportion is even higher in very young children in whom diabetes is not recognised early. Forty per cent of children diagnosed under 4 years of age in an Oxford Regional cohort in 1990 had ketoacidosis at diagnosis and in 25 per cent it was severe, i.e. arterial pH < 7.1. After the initial diagnosis of type 1 diabetes, admission rates with diabetic ketoacidosis during childhood are around 0.2 per patient year. Episodes are usually associated with intercurrent illness. In the older child, insulin omission and psychological disturbance may result in recurrent hospital admissions.
Sadly, ketoacidosis is still the major cause of death in children with type 1 diabetes. Approximately one per cent of episodes among children may be complicated by cerebral oedema, which is the major cause of type 1 diabetes-related death in children under the age of 12 years. Ketoacidosis is the most common cause of death outside hospital in teenagers and young adults with type 1 diabetes.
Diabetic ketoacidosis is the leading cause of death among children with type 1 diabetes.
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Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...