Clinical Profile of Children With Diabetic Ketoacidosis and Related Cerebral Edema in a Tertiary Care Hospital From Southern Kerala

Krishnan, Rekha; Sugunan, Sheeja; Sasidharan, Bindusha; Hariprasad, P G

doi:10.32677/ijch.2018.v05.i02.002

Cited by 2 publications

(7 citation statements)

References 29 publications

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“…Among the 6 studies identified which addressed our primary objective, 5 studies found no significant association between younger age and higher risk of CE (5e7, 18,19). In contrast, a large case series of fair quality, which included both cases from the literature and cases followed by the author, found that age <5 years was associated with higher risk of CE (17).…”

Section: Discussionmentioning

confidence: 95%

“…The conclusions of the study were limited by the retrospective design and the definition of CE as receiving mannitol or 3% hypertonic saline, in contrast with other studies. In a retrospective study from India, Krishnan et al (19) showed no difference in the mean age of children who developed CE (9.65AE3.63 years) and those who did not (9.00AE3.87 years). There was an extremely high rate of CE (23.5%) in this study with 100% survival.…”

Section: Discussionmentioning

confidence: 95%

“…No statistically significant difference in age between CE cases and matched control subjects with DKA was found (7). Two recent retrospective studies in the United States (18) and India (19) found no statistically significant difference in age between children with and without CE. DKA Table 2 (20e46) describes the findings of the 27 studies published over the last 30 years which reported the incidence of DKA or severe DKA based on age categories.…”

Section: Methodsmentioning

confidence: 92%

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Is Age a Risk Factor for Cerebral Edema in Children With Diabetic Ketoacidosis? A Literature Review

Glackin

Metzger

Hanås

et al. 2020

Canadian Journal of Diabetes

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Key MessagesPublished data do not support the view that young age is a risk factor for cerebral edema development in children with diabetic ketoacidosis at the time of diagnosis. Younger children are at a higher risk for the development of diabetic ketoacidosis, in particular during the first 2 to 3 years of life. Whether diabetic ketoacidosis is more severe in younger children remains unclear. Keywords:cerebral edema children diabetic ketoacidosis review type 1 diabetes younger age a b s t r a c t Cerebral edema (CE) is a rare but potentially fatal complication of diabetic ketoacidosis (DKA) in children with type 1 diabetes. CE is frequently mentioned as being more common in young children. The primary objective of this study was to review the evidence suggesting that younger age is a risk factor for the development of CE during DKA. The secondary objective was to assess if younger children are at a higher risk of DKA and severe DKA. A literature review was performed, and studies which reported the frequency of CE, DKA and severe DKA in children <3 and 3 to 5 years of age were included. Among the 6 studies reporting the frequency of CE that were identified, 5 good-quality studies found no significant association between younger age and higher risk of CE. Twenty-seven studies (DKA frequency: 11.3% to 54%) reported DKA frequency as a function of age. Most published studies found a higher frequency of DKA in children <5 years of age (20/25 studies), and in particular in those in the first 2 to 3 years of life (8/8 studies). There was inconclusive evidence to determine whether the severity of DKA was influenced by age. In conclusion, the commonly held view that CE is more common in younger children is not supported by the existing literature. Published data suggest that DKA (and possibly severe DKA) is more common in very young children. Regardless of age, all children with DKA should be monitored carefully for the development of CE.Ó 2019 Canadian Diabetes Association.Mots clés: oedème cérébral enfants acidocétose diabétique revue diabète de type 1 de plus bas âge r é s u m é L'oedème cérébral (OC) est une complication rare, mais potentiellement fatale de l'acidocétose diabétique (ACD) chez les enfants atteints du diabète de type 1. On mentionne souvent que l'OC est plus fréquent chez les jeunes enfants. L'objectif principal de la présente étude était d'examiner les données probantes qui montrent que les enfants de plus bas âge qui sont atteints d'ACD sont exposés au risque de développer un OC. L'objectif secondaire était d'évaluer si les enfants de plus bas âge sont exposés à un risque plus élevé d'ACD et d'ACD grave. Dans la revue de littérature réalisée, nous avons sélectionné les études qui rapportaient la fréquence de l'OC, l'ACD et l'ACD grave chez les enfants âgés de < 3 ans et de 3

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 95%

Section: Methodsmentioning

confidence: 92%

See 1 more Smart Citation

Is Age a Risk Factor for Cerebral Edema in Children With Diabetic Ketoacidosis? A Literature Review

Glackin

Metzger

Hanås

et al. 2020

Canadian Journal of Diabetes

View full text Add to dashboard Cite

show abstract

“…In this study, males (56%) were affected more as compared to females (44%), this is in similarity with the studies done by Bhardwaj et al, Ganesh et al, and Prasad et al 18,20,21 However, a difference was observed in studies conducted by Barot et al, Kanwal et al, Krishnan et al where a female preponderance was observed. 18,22,23 This might be due to difference in study area and design.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, the most common presenting complaint was respiratory distress (72%) followed by vomiting (54%), where as in studies conducted by Kanwal et al, Barot et al, Krishnan et al, Vasudev et al and Pozoa et al vomiting was the prime complaint in the patients. 19,[23][24][25] However, according to Bhardwaj et al abdominal pain (62%) was the most common symptom noted followed by polyuria (58.6%), fast breathing (58.6%) and vomiting (55.1%). 18 In a study done by Ganesh et al polyuria (65%) was the most common presenting complaint followed by fever (33%), vomiting (23%) and pain in abdomen (23%).…”

Section: Discussionmentioning

confidence: 99%

Clinical and biochemical profile among children admitted with diabetic ketoacidosis and their correlation in prognosis of children admitted in pediatric intensive care unit

Choudhary,

Asif,

Goyal

2024

Int J Contemp Pediatr

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Background: The present study aimed to analyse clinical and biochemical profile among children admitted with diabetic ketoacidosis (DKA) and their correlation in prognosis of children admitted in PICU. Methods: The prospective study was conducted in pediatric intensive care unit (PICU) of RNT medical college, Udaipur among 50 DKA children in the age group of (1 month-18 years) for a period of one year after approval of institutional ethics committee. In the study, HbA1c level was measured by automated analyzer method to find out the past 3-month duration of glycemic control. Pearson correlation coefficient was used to find the correlation between serum osmolality and GCS, serum osmolality and duration of hospital stay, correlation between HbA1c levels and GCS, HbA1c levels and duration of hospital stay. Result: The most common presenting complaint was respiratory distress (72%) followed by vomiting (54%), polyuria (34%), polydipsia (24%), pain in abdomen (24%), fever (24%) and polyphagia (4%). There was negative correlation between HbA1c and depressed sensorium, i.e. patients with higher HbA1c levels had poor GCS and it was statistically significant. Patients with higher HbA1c levels had longer duration of hospital stay, although this observation was not statistically significant. Conclusions: The present study concluded that patients presenting with DKA had severe derangement in acid-base parameters. The DKA patients who had higher serum osmolality and poor glycemic control had depressed sensorium at the time of hospital admission and a longer recovery time leading to a prolonged hospital stay, adding to the morbidity associated with the disease.

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Clinical Profile of Children With Diabetic Ketoacidosis and Related Cerebral Edema in a Tertiary Care Hospital From Southern Kerala

Cited by 2 publications

References 29 publications

Is Age a Risk Factor for Cerebral Edema in Children With Diabetic Ketoacidosis? A Literature Review

Is Age a Risk Factor for Cerebral Edema in Children With Diabetic Ketoacidosis? A Literature Review

Clinical and biochemical profile among children admitted with diabetic ketoacidosis and their correlation in prognosis of children admitted in pediatric intensive care unit

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