European Society for Paediatric Endocrinology/Lawson Wilkins Pediatric Endocrine Society Consensus Statement on Diabetic Ketoacidosis in Children and Adolescents

Sperling, Mark A.; Acerini, Carlo L.; Bohn, Desmond; Daneman, Denis; Danne, Thomas; Glaser, Nicole; Hanås, Ragnar; Hintz, Raymond L.; Levitsky, Lynne L.; Savage, Martin O.; Tasker, Robert C.; Wolfsdorf, Joseph I.

doi:10.1542/peds.113.2.e133

Cited by 275 publications

(311 citation statements)

References 113 publications

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“…The even higher rate of DKA in the present study may be a reason for concern as errors in pump use could have been a potential cause. However, the significantly higher HbA 1c in the DKA group, and the lack of an association with age or CSII duration, make it likely that similar risk factors for DKA apply with CSII as with injection therapy [29].…”

Section: Discussionmentioning

confidence: 97%

Establishing glycaemic control with continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes: experience of the PedPump Study in 17 countries

et al. 2008

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Aims/hypothesis To assess the use of paediatric continuous subcutaneous infusion (CSII) under real-life conditions by analysing data recorded for up to 90 days and relating them to outcome.Methods Pump programming data from patients aged 0-18 years treated with CSII in 30 centres from 16 European countries and Israel were recorded during routine clinical visits. HbA 1c was measured centrally.Electronic supplementary material The online version of this article

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Section: Discussionmentioning

confidence: 97%

Establishing glycaemic control with continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes: experience of the PedPump Study in 17 countries

et al. 2008

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“…Pubertal development was assessed according to Tanner (16). Diagnosis of diabetic ketoacidosis was confirmed according to the recently published guidelines (17). The whole set of data is presented in Table 1.…”

Section: Clinical Examinationmentioning

confidence: 99%

Metabolic decompensation in children with type 1 diabetes mellitus associated with increased serum levels of the soluble leptin receptor

Kratzsch

Knerr²,

Galler³

et al. 2006

eur j endocrinol

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Objective: Type 1 diabetes mellitus (T1DM) leads to increased serum levels of the soluble leptin receptor (sOB-R) by an as yet unknown cellular mechanism. The aim of our study was to investigate potential metabolic factors that may be associated with the induction of the sOB-R release from its membrane receptor. Materials and methods: Twenty-five children (aged between 1.5 and 17.0 years) were studied at the onset of T1DM. Blood samples were collected before (nZ25), during the first 18 h (meanGS.D. 11.1G 4.3 h, nZ16) and 92 h (47.5G22.5 h; nZ14) after beginning insulin therapy. Serum sOB-R and leptin levels were determined by in-house immunoassays. Results: The sOBR-level and the molar sOB-R/leptin ratio were significantly higher before than after starting insulin treatment (P!0.05). In contrast, leptin levels were significantly lower (P!0.05) before insulin therapy. The correlation between sOB-R and blood glucose (rZ0.49; P!0.05), as well as sOB-R with parameters of ketoacidosis, such as pH (rZK0.72), base excess (rZK0.70), and bicarbonate (rZK0.69) (P!0.0001) at diagnosis of T1DM remained significant during the first 18 h of insulin treatment. Multiple regression analysis revealed that base excess predicted 41.0% (P!0.001), age 16.4% (P!0.05), and height SDS 13.9% (P!0.01) of the sOB-R variance. Conclusions: Metabolic decompensation in children with new onset T1DM is associated with dramatic changes of the leptin axis; serum levels of sOB-R are elevated and of leptin are reduced. The molar excess of sOB-R over leptin (median 11.3) in this condition may contribute to leptin insensitivity. Upregulation of the soluble leptin receptor appears to be a basic mechanism to compensate for intracellular substrate deficiency and energy-deprivation state.European Journal of Endocrinology 155 609-614

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“…Approximately 10~70% of these patients experience DKA [14], which, in children, Factors that contribute to the incidence of DKA include poorly metabolic control [16] and a rapid decrease in pancreatic beta cell function [17]. In a recent study, age under 12 years, lower serum C-peptide level, preceding infection, and delayed diagnosis were strongly related to DKA; and severe DKA was increased in situations where there was limited parental education level and a prior episode of infection [18].…”

Section: Discussionmentioning

confidence: 99%

Clinical and Laboratory Characteristics of Pediatric Diabetic Ketoacidosis: A Single-Center Study

et al. 2017

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Background: Diabetic ketoacidosis (DKA) is an acute complication of pediatric type 1 diabetes mellitus (T1DM). We aimed to determine the risk factors and clinical characteristics of children and adolescents with DKA. Methods: We retrospectively evaluated 59 episodes of DKA in 43 patients who were hospitalized for DKA between January 2006 and December 2015. DKA was classified as mild, moderate, or severe, according to patient history of DKA. The clinical and laboratory characteristics of these subgroups were compared. Results: The average patient age was 11.98 ± 4.40 years (range, 1.3~17.9 years). Moderate episodes were the most common, with 21 episodes (35.6%), followed by 19 severe (32.2%) and 19 mild episodes (32.2%). Significant differences were observed between the subgroups regarding their characteristics of aggravated. Severe DKA episodes were more often observed during the winter season. Recurrent DKA cases were determined in 31 episodes (52.5%) who were significantly older, had higher body mass index, and lower serum C-peptide levels than the newly diagnosed DKA group. Female patients experienced severe and moderate cases more frequently (P = 0.041), which included two deaths. Only blood glucoseCorresponding author: Min Sun Kim Department of Pediatrics, Chonbuk National University Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Korea, E-mail: children@jbnu.ac.kr Received: Feb. 20, 2017; Revised: Jun. 5, 2017; Accepted: Jul. 18, 2017 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/bync/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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European Society for Paediatric Endocrinology/Lawson Wilkins Pediatric Endocrine Society Consensus Statement on Diabetic Ketoacidosis in Children and Adolescents

Cited by 275 publications

References 113 publications

Establishing glycaemic control with continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes: experience of the PedPump Study in 17 countries

Establishing glycaemic control with continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes: experience of the PedPump Study in 17 countries

Metabolic decompensation in children with type 1 diabetes mellitus associated with increased serum levels of the soluble leptin receptor

Clinical and Laboratory Characteristics of Pediatric Diabetic Ketoacidosis: A Single-Center Study

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