Characteristics of pediatric diabetic ketoacidosis patients in Saudi Arabia

ABSTRACT

To evaluate the clinical and biochemical characteristics of children with diabetic ketoacidosis [DKA]. In this retrospective study conducted between June 2012 and November 2013 at the King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, we evaluated pediatric DKA admissions from 1995-2008 [Phase 1]. From the case files, we obtained information related to patients' age, gender, weight, presenting complaints, serum biochemical profile, and management. 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 non-compliance 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. The notable findings in this study, such as, higher mean age of presentation, high rate of non-compliance to insulin as the cause of precipitation, and a high prevalence of abdominal pain at presentation should be followed up with further comparative studies