DIABETIC KETOACIDOSIS

PATTERN OF PRECIPITATING FACTORS AMONG CHILDREN IN A TERTIARY CARE HOSPITAL IN BANGLADESH

Abstract

INTRODUCTION
Diabetic ketoacidosis is a major complication of childhood type 1 and type 2 diabetes mellitus and is associated with increased risk of morbidity and mortality. Infections, non-compliance and co-morbid states are most important precipitating causes. Proper identification of the precipitating factor is very important in management of DKA. There are very few published large studies from Bangladesh. For this reason, this study evaluated fifty children with DKA and identified their precipitating factors.

METHDOLOGY
This observational study was done among admitted children with DKA in the Department of Paediatrics of BIRDEM General Hospital during study period between September 2016 to February 2017. All children (<18 years) with a diagnosis of DKA, whether previously known to have diabetes or newly diagnosed case were included in the study while patients having other causes of acidosis like chronic kidney failure, diarrhea were excluded from the study.

RESULTS
Fifty children were admitted with DKA. Seventy percent were new cases and the remaining (30%) were known DM patient. Majority were female (62%). Mean age was 9.31 years with 4.40 standard deviation among affected children. Infection was the most common (62%) precipitating factor followed by insulin omission (10%).

CONCLUSION
In this study, infection was the most common precipitating factor for DKA. Knowledge of precipitating factors and clinical features of DKA will help in early diagnosis of DKA among children and thereby reduce morbidity among them.