[Diabetic ketoacidosis in children: treatment profile at a university hospital]

Abstract

Objective: To evaluate the profile of children with diabetic ketoacidosis (DKA) treated at the UNICAMP 'Hospital de Clínicas'.

Methods: Retrospective and descriptive study of clinical and laboratory variables of 74 admissions related to 49 patients bearers of DKA, between January 1994 and December 2003.

Results: Twelve patients were admitted more than once, 27 were females and ages ranged from 0.9 to 14.5 years. The mean time from DM1 diagnosis to admission was 3+/-3.1 years and 20 cases presented with DKA at the onset of DM1. DKA was severe in 51% and moderate in 30%, at admission 17 patients presented with shock and 13 coma. The time needed for normalization of glycemia, pH, and bicarbonate had a significant positive correlation with the initial value. Intravenous bicarbonate was administered in only 3 admissions. The initial potassium value ranged from 3.1 to 5.9 mEq/l; in 8% the value was lower than 3.5 and in 62% higher than 4.5. Hypoglycemia occurred in 10 admissions and cerebral edema and death in one. The total time of treatment had a significant correlation with the time of fluid replacement, place of admission and time needed for pH normalization.

Conclusion: The analyzed sample showed a predominance of female patients, less than ten years of age with a severe manifestation of the disease. However, evolution was good with few complications. Most of the admissions refer to a small number of patients.