Management of Diabetic Ketoacidosis in Children and Adolescents with Type 1 Diabetes Mellitus

Castellanos, Luz E.; Tuffaha, Marwa; Koren, Dorit; Levitsky, Lynne L.

doi:10.1007/s40272-020-00397-0

Cited by 54 publications

(62 citation statements)

References 136 publications

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“…Our multivariate logistic regression analysis showed that heart rate ,diastolic blood pressure and stage of severity were independently associated with a higher risk of hyperlactatemia in DKA. DKA is often accompanied by dehydration [33]. Patients with DKA may develop hypovolemia due to fluid loss [34].…”

Section: Discussionmentioning

confidence: 99%

Hyperlactatemia associated with diabetic ketoacidosis in pediatric intensive care unit

Liu

Yan

2021

BMC Endocr Disord

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Background Children with diabetic ketoacidosis often have elevated lactate. In this study, we investigated the clinical variables associated with hyperlactatemia in children with diabetic ketoacidosis. Methods We designed a single-center retrospective descriptive study of children with diabetic ketoacidosis in a pediatric intensive care unit. Results Of the 107 patients with diabetic ketoacidosis included in the analysis, 61 developed hyperlactatemia. Multivariate logistic regression analysis showed that heart rate (p = 0.003),diastolic blood pressure (p = 0.001) and stage of severity (p = 0.042) were independently associated with the development of hyperlactatemia in diabetic ketoacidosis. We found that lactate level was not significantly associated with length of hospital stay (p = 0.115) or the length of time to diabetic ketoacidosis resolution (p = 0.143). Conclusions Children with diabetic ketoacidosis presenting with severer stage, elevated heart rate and higher diastolic blood pressure may be prone to hyperlactatemia. Hyperlactatemia was not associated with length of time to DKA resolution and length of hospital stay.

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Section: Discussionmentioning

confidence: 99%

Hyperlactatemia associated with diabetic ketoacidosis in pediatric intensive care unit

Liu

Yan

2021

BMC Endocr Disord

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“…Risk factors for the development of AKI in children and adolescents with diabetes are numerous and include, but are not limited to, episodes of DKA as well as the presence of acute and chronic hyperglycemia. DKA is a severe risk factor for the development of AKI, particularly in youth with T1D, and is characterized by a combination of hyperglycemia, metabolic acidosis, and the production of ketone bodies ( 54 , 55 ). DKA is currently the leading cause of hospitalization, morbidity, and mortality in youth with T1D ( 14 , 56 , 57 ) and in a study by Hursh et al up to 64% of youth with T1D hospitalized for DKA developed AKI ( 14 ).…”

Section: Epidemiology and Pathophysiology Of Aki In Diabetesmentioning

confidence: 99%

“…This percentage increased to 85% if the individual required admission to the Intensive Care Unit ( 14 ). Severe hyperglycemia associated with DKA leads to osmotic diuresis, dehydration, and significant pre-renal AKI ( 54 , 55 ).…”

Section: Epidemiology and Pathophysiology Of Aki In Diabetesmentioning

confidence: 99%

Acute Kidney Injury in Pediatric Diabetic Kidney Disease

et al. 2021

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Diabetic kidney disease (DKD) is a common complication of type 1 and 2 diabetes and often presents during adolescence and young adulthood. Given the growing incidence of both type 1 and type 2 diabetes in children and adolescents, DKD represents a significant public health problem. Acute kidney injury (AKI) in youth with diabetes is strongly associated with risk of DKD development. This review will summarize the epidemiology and pathophysiology of AKI in children with diabetes, the relationship between AKI and DKD, and the potential therapeutic interventions. Finally, we will appraise the impact of the recent COVID-19 infection pandemic on AKI in children with diabetes.

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“…Diabetes and thyroid diseases are the two most common diseases in the department of endocrinology, and the two diseases are closely related (4). Studies (5,6) have shown that patients with T1DM or type 2 diabetes mellitus (T2DM) may have abnormal thyroid function. In addition to promote the growth and development of tissue, thyroid hormones can also affect the metabolism of sugar, fat and protein (7), and it's been reported that it participates in the development of T2DM (8,9).…”

Section: Original Articlementioning

confidence: 99%

The thyroid hormone levels and glucose and lipid metabolism in children with type 1 diabetes: a correlation analysis

Yuan¹,

Sun²,

Liu³

et al. 2021

Transl Pediatr

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Background: Type 1 diabetes mellitus (T1DM) is common in clinical setting, the relationship between thyroid hormone levels and glucose and lipid metabolism in patients with T1DM remains unclear. We attempted to analyze the correlation of thyroid hormone levels and blood glucose and lipid metabolism in children with normal thyroid function.Methods: Children with T1DM were selected, and 85 healthy children who underwent physical examinations in our hospital as control group. The characteristics and laboratory testing results were compared, the correlation of thyroid hormone levels with blood glucose and blood lipids was analyzed by Pearson correlation analysis. Results: A total of 167 participants were included. the low-density lipoprotein-cholesterol (LDL-C), triglyceride (TG), fasting blood glucose (FBG), and glycated hemoglobin (HbAlc) in T1DM patients were higher than those in healthy controls, while the high-density lipoprotein-cholesterol (HDL-C), thyroid stimulating hormone (TSH) and free triiodothyronine (FT3) in T1DM patients were lower than that of healthy children (all P<0.05). TSH was positively correlated with LDL-C (r=0.169, P=0.032), TC (r=0.182, P=0.017) and TG (r=0.197, P=0.008), negatively correlated with FBG (r=−0.196, P=0.023) and HbAlc (r=−0.328, P=0.002). FT3 was negatively correlated with TG (r=−0.182, P=0.011), FBG (r=−0.184, P=0.009)and HbAlc (r=−0.223, P=0.005). TG in the high TSH group and the middle TSH group is higher than that of low TSH group. However, FBG and HbAlc were lower than those in the low TSH group (all P<0.05).Compared with the low FT3 group, the TG, FBG and HbAlc decreased in the high and middle FT3 group (all P<0.05). Conclusions:The serum TSH are closely associated with FT3 and glycolipid metabolism in children with T1DM, which may be the useful indicators to assess the severity of T1DM in clinical settings to provide insights into the management of T1DM.

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Management of Diabetic Ketoacidosis in Children and Adolescents with Type 1 Diabetes Mellitus

Cited by 54 publications

References 136 publications

Hyperlactatemia associated with diabetic ketoacidosis in pediatric intensive care unit

Hyperlactatemia associated with diabetic ketoacidosis in pediatric intensive care unit

Acute Kidney Injury in Pediatric Diabetic Kidney Disease

The thyroid hormone levels and glucose and lipid metabolism in children with type 1 diabetes: a correlation analysis

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