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DIABETIC KETOACIDOSIS IN PAEDIATRICS Running title: Diuretic Pre-Blood Transfusion

Abdulrahim Mohammed Alamoudi 1*, Rehab Badder Almohsin 2 , Fatimah Fayiz Alghanim 3 , Murtadha Hussain Alrashed 3 , Hadeel Abdulrahman Almehery 4 , Bader Hussain Almogheer 5 , Hamdan Dhafer Alshehri 5 , Waad Abdullah Aljubairah 6 , Alanoud Thamer Aldarsouny 7 , Amal Mohammed Alsomali 8

Diabetic ketoacidosis (DKA) is one of the most important emergencies in paediatric population. Children with diabetic ketoacidosis do not present clinically with the typical manifestations of polydipsia, polyurea, polyphagia, confusion, abdominal pain, vomiting, and dyspnoea adults. Therefore, a high index of suspicion should be there for appropriate timely diagnosis and management of this condition among paediatric age group. The most common risk factors for paediatric ketoacidosis are infection, incompliance with insulin regimen, and psychological stress. Though the most important laboratory tests for diagnosis of DKA in children are the blood glucose level and arterial blood gases, many other lab tests can help confirmation of the diagnosis, predicting the outcome, and monitoring of treatment. The mainstay treatment lines are insulin therapy and correction of hypovolemia. Electrolyte imbalance and cardiac monitoring are fundamental during the management plan, This article will discuss the epidemiology, aetiology, risk factors, pathophysiology, clinical presentation, diagnosis, and management of diabetic ketoacidosis in paediatric population. Keywords: Diabetic Ketoacidosis, DKA, paediatrics.

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