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Diabetic Ketoacidosis, Pediatric

Nicole S. Glaser, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Severe metabolic derangement in patients with diabetes mellitus secondary to insulin deficiency and/or stress hormone excess

  • Clinical features include hyperglycemia, ketosis, metaboli...

DIAGNOSIS

HISTORY

  • Symptoms of new-onset diabetes (polyuria, polydipsia, weight loss)

  • Nausea, vomiting, abdominal pain, weakness, lethargy

PHYSICAL EXAM

  • Vital signs: tachycardia, tachypnea (deep, “Kussmaul...

TREATMENT

GENERAL MEASURES

Initial emergency treatment consists of fluid resuscitation to insure hemodynamic stability. Most DKA patients require admission to a pediatric critical care unit or other un...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Recommended monitoring: 
  • Frequent (at least hourly) assessment of mental status and perfusion

  • Hourly vital signs

  • Cardiac monitor and pulse oximeter

  • ...

ADDITIONAL READING

  • Glaser N. Cerebral injury and cerebral edema in children with diabetic ketoacidosis: could cerebral ischemia and reperfusion injury be involved? Pediatr Diabetes.  2009;10(8):5...

CODES

ICD9

  • 250.11 Diabetes with ketoacidosis, type I [juvenile type], not stated as uncontrolled

  • 250.10 Diabetes with ketoacidosis, type II or unspecified type, not stated as uncontrolled

  • 250.1 Diabetes ...

FAQ

  • Q: Is DKA in children with known diabetes usually caused by infection or other illness?

  • A: Diabetes mismanagement resulting in inappropriate insulin omission is a far more frequent cause of DKA in ...

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