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TITLE:

EVALUATION CHARACTERISTICS OF DIABETIC KETOACIDOSIS IN CHILDREN IN SAUDI ARABIA

AUTHORS:

ASaeed Mohammed Almalki1*, Amnah Khalid Zakri1 , Amal Ahmed Zalah1 , Athar Mohammed Arishi1 , Ghalia Alhussain Alhazmi1 , Afnan Ahmed Hamod Zegily1 , Tahani Ahmed Douf1 , Aisha Hussain Hothan1 , Meshari Fahad Alasmari1

ABSTRACT:

Objectives: To evaluate the clinical and biochemical characteristics of children with diabetic ketoacidosis (DKA). Methods: In this retrospective study conducted from January to October 2018 in Saudi Arabia we evaluated pediatric DKA admissions from 2014-2018. From the case files, we obtained information related to patients’ age, gender, weight, presenting complaints, serum biochemical profile, and management. Results: This study included 373 DKA admissions with a median age of 11 years (interquartile range [IQR]: 8-13). The patients in the subgroup of age more than 10 years old had the highest proportion of admissions (n=250, 67%, p <0.000). The median duration of diagnosis of diabetes mellitus (DM) was 3 years (IQR: 2-6). New-onset DM was 47%. Predominant precipitating cause was acute illness, mostly viral syndrome in 22% of all cases, and noncompliance to insulin regimen was in 79% of the diagnosed diabetic cases. Blood glucose, pH, anion gap, serum osmolality, serum potassium, and serum phosphate showed the highest change during the initial 6 hours of management, while trends of serum bicarbonate and blood urea nitrogen demonstrated a predominant change in the initial 12 hours. Conclusion: The notable findings in this study, such as, higher mean age of presentation, high rate of noncompliance to insulin as the cause of precipitation, and a high prevalence of abdominal pain at presentation should be followed up with further comparative studies. Keywords: DKA, Children, Saudi Arabia.

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