Euthyroid sick syndrome in children with diabetic ketoacidosis

ABSTRACT

To investigate characteristics of euthyroid sick syndrome [ESS] in children with diabetic ketoacidosis [DKA]. This retrospective study was carried out between May 2010 and April 2013 at the Pediatric Department of Shandong Provincial Hospital, Shandong University, Shandong, China. Diabetic ketoacidosis children were divided into 2 groups euthyroidism [group one, n=30] and ESS [group 2, n=40]. C-peptide, glycosylated hemoglobin [HbA1c], bicarbonate, anion gap [AG], free triiodothyronine [FT3], free thyroxine [FT4], and thyrotropin [TSH] levels were measured before and after 7 days of insulin treatment. Daily blood glucose [BG] profiles were recorded. Glycosylated hemoglobin, AG, the mean daily BG, and fasting blood glucose levels were higher, and bicarbonate, FT3, FT4, and TSH levels were lower in group 2 than in group one [all p<0.05]. Free triiodothyronine [r=-0.593, p<0.001] and FT4 [r=-0.402, p=0.001] were negatively correlated with HbA1c. Free triiodothyronine [r=-0.438, p<0.001] and FT4 [r=-0.505, p<0.001] were negatively correlated with AG, and FT3 [r=0.503, p<0.001] and FT4 [r=0.448, p<0.001] were positively correlated with bicarbonate. Diabetic ketoacidosis children with ESS have poor diabetic control. Free thyroid hormones are associated with the severity of DKA