704 results match your criteria Pediatrics Diabetic Ketoacidosis


Ischaemic Haemorrhagic Stroke in a Child with New Onset Type 1 Diabetes Mellitus.

Eur Endocrinol 2018 Apr 18;14(1):59-61. Epub 2018 Apr 18.

University Malaya Pediatric and Child Health Research Group, University Malaya, Kuala Lumpur, Malaysia.

Cerebral oedema is the most common neurological complication of diabetic ketoacidosis (DKA). However, ischaemic and haemorrhagic brain injury has been reported infrequently. A 10-year old girl who was previously well presented with severe DKA. Read More

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Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State: A Consensus Statement from the International Society for Pediatric and Adolescent Diabetes.

Pediatr Diabetes 2018 Jun 13. Epub 2018 Jun 13.

Institute of Maternal and Child Research, School of Medicine, University of Chile, Santiago, Chile.

Recommendations concerning fluid management have been modified to reflect recent findings from a randomized controlled clinical trial showing no difference in cerebral injury in patients rehydrated at different rates with either 0.45% or 0.9% saline. Read More

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June 2018
2 Reads

Fluid Composition, Infusion Rate, and Brain Injury in Diabetic Ketoacidosis.

Authors:
Mark A Sperling

N Engl J Med 2018 06;378(24):2336-2338

From the Department of Pediatrics, Division of Endocrinology and Diabetes, Icahn School of Medicine at Mt. Sinai, New York.

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June 2018
1 Read

Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis.

N Engl J Med 2018 06;378(24):2275-2287

From the Departments of Emergency Medicine (N.K., L.T.), Pediatrics (N.K., N.S.G.), and Psychology (S.G., C.S.P.), University of California Davis Health, University of California, Davis, School of Medicine, Sacramento; the Department of Pediatrics, University of Utah School of Medicine, Salt Lake City (J.E.S., C.S.O., T.C.C., J.M.D.); the Division of Emergency Medicine, Department of Pediatrics, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus (M.J.S.); the Division of Emergency Medicine, Department of Pediatrics, Colorado Children's Hospital, University of Colorado-Denver School of Medicine, Aurora (A.R.); the Division of Emergency Medicine, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston (J.K.M.); the Division of Emergency Medicine, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania (S.R.M.), and the Division of Emergency Medicine, Nemours/A.I. duPont Hospital for Children, Sidney Kimmel Medical College at Thomas Jefferson University (J.E.B., A.D.D.) - both in Philadelphia; the Division of Emergency Medicine, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston (L.E.N.); the Departments of Emergency Medicine and Pediatrics, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence (A.G.); the Division of Emergency Medicine, Department of Pediatrics, Children's National Medical Center, George Washington School of Medicine and Health Sciences, Washington, DC (K.M.B.); the Division of Emergency Medicine, Department of Pediatrics, St. Louis Children's Hospital, Washington University School of Medicine in St. Louis, St. Louis (K.S.Q.); the Division of Emergency Medicine, Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (J.L.T.); and the Division of Emergency Medicine, Department of Pediatrics, New York Presbyterian Morgan Stanley Children's Hospital, Columbia University College of Physicians and Surgeons, New York (M.Y.K.); and the Department of Psychology, Tufts University, Medford, MA (C.S.P.).

Background: Diabetic ketoacidosis in children may cause brain injuries ranging from mild to severe. Whether intravenous fluids contribute to these injuries has been debated for decades.

Methods: We conducted a 13-center, randomized, controlled trial that examined the effects of the rate of administration and the sodium chloride content of intravenous fluids on neurologic outcomes in children with diabetic ketoacidosis. Read More

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June 2018
1 Read

Ever-Increasing Insulin-Requiring Patients Globally.

Diabetes Technol Ther 2018 Jun 6;20(S2):S21-S24. Epub 2018 Jun 6.

1 Department of Medicine and Pediatrics, University of Colorado Denver , Aurora, Colorado.

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Comparison of subcutaneous insulin aspart and intravenous regular insulin for the treatment of mild and moderate diabetic ketoacidosis in pediatric patients.

Endocrine 2018 May 24. Epub 2018 May 24.

Associate Professor of Biostatistics, Hamedan University of Medical Sciences, Hamedan, Iran.

Purpose: To compare the safety/efficacy of intermittent subcutaneous rapid-acting insulin aspart with the standard low-dose intravenous infusion protocol of regular insulin for treatment of pediatric diabetic-ketoacidosis.

Methods: For a prospective randomized-controlled clinical trial on 50 children/adolescents with mild/moderate diabetic-ketoacidosis, the diagnostic criteria for ketoacidosis included: blood glucose level >250 mg/dl, ketonuria>++, venous pH <7.3 and/or bicarbonate <15 mEq/l. Read More

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Spectrum of complications of severe DKA in children in pediatric Intensive Care Unit.

Pak J Med Sci 2018 Jan-Feb;34(1):106-109

Dr. Khadija Nuzhat Humayun, FCPS. Department of Pediatrics and Child Health, Aga Khan University Hospital, Karachi, Pakistan.

Objectives: To describe the spectrum of complications of Diabetic Ketoacidosis (DKA) observed in children admitted with severe DKA.

Methods: Retrospective review of the medical records of all children admitted with the diagnosis of severe DKA in Pediatric Intensive Care Unit (PICU) of the Aga Khan University Hospital, from January 2010 to December 2015 was done. Data was collected on a structured proforma and descriptive statistics were applied. Read More

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Diabetic ketoacidosis at the onset of Type 1 diabetes in young children Is it time to launch a tailored campaign for DKA prevention in children <5 years?

Acta Biomed 2018 Jan 8;89(1):67-71. Epub 2018 Jan 8.

Center on health systems organization, quality and sustainability. Children Hospital and University of Parma, Parma, Italy.

Aim: To analyze clinical characteristics associated with the occurrence of diabetic ketoacidosis (DKA) at the onset of type 1 diabetes (T1D) in children aged <5 years in order to identify early signs or symptoms useful to prevent DKA appearance.

Methods: Data of patients  with newly diagnosed TID aged <5 years (Group 1) and 6-10 years old  (Group 2) coming from the province of Parma were collected in the period 2012-2016.

Results: Mild/moderate ketoacidosis at diabetes diagnosis occurred more frequently in Group 1 than in Group 2 patients (p<0. Read More

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January 2018

Risk of ketoacidosis in children at the time of diabetes mellitus diagnosis by primary caregiver status: a population-based retrospective cohort study.

CMAJ 2018 Apr;190(14):E416-E421

Department of Pediatrics (Nakhla, Legault, Li), The Montreal Children's Hospital, McGill University; Research Institute of the McGill University Health Centre (Nakhla, Rahme, Legault, Li), Montréal, Que.; Institut national de santé publique du Québec (Simard, Larocque), Québec, Que.

Background: Diabetic ketoacidosis is the leading cause of death among children with type 1 diabetes mellitus, and is an avoidable complication at first-time diagnosis of diabetes. Because having a usual provider of primary care is important in improving health outcomes for children, we tested the association between having a usual provider of care and risk of diabetic ketoacidosis at onset of diabetes.

Methods: Using linked health administrative data for the province of Quebec, we conducted a population-based retrospective cohort study of children aged 1-17 years in whom diabetes was diagnosed from 2006 to 2015. Read More

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April 2018
3 Reads

Perception, attitude, and satisfaction of paediatric physicians and nurses towards clinical practice guidelines at a university teaching hospital.

J Eval Clin Pract 2018 Apr 3. Epub 2018 Apr 3.

Department of Paediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Rationale, Aims, And Objectives: To explore perception, attitude, and satisfaction of paediatric clinicians, trainees, and nurses at King Khalid University Hospital towards clinical practice guidelines (CPGs) including the locally adapted diabetic ketoacidosis CPG (DKA-CPG).

Methods: A cross-sectional survey was distributed to 260 doctors and nurses working in the paediatrics department.

Results: The response rate was 95. Read More

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April 2018
3 Reads

Metabolic control of type 1 diabetes in youth with autism spectrum disorder: A multicenter Diabetes-Patienten-Verlaufsdokumentation analysis based on 61 749 patients up to 20 years of age.

Pediatr Diabetes 2018 Mar 26. Epub 2018 Mar 26.

University of Ulm, Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology, Ulm, Germany.

Background: A paucity of reports in the literature exists concerning the co-existence between autism spectrum disorder (ASD) and type 1 diabetes (T1D).

Objective: To compare clinical characteristics, diabetes management and metabolic control in youth with T1D and ASD (T1D-ASD) with youth without ASD (T1D-non ASD).

Methods: Using the German/Austrian diabetes patient follow-up registry, this study analyzed aggregated data from the last available year of observation for each patient with T1D, ages 1-20 with consistent data on insulin regimen and glycated hemoglobin (A1C), between January, 2005 and March, 2017. Read More

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March 2018
2 Reads

Presenting predictors and temporal trends of treatment-related outcomes in diabetic ketoacidosis.

Pediatr Diabetes 2018 Mar 24. Epub 2018 Mar 24.

Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Objective: This study examines temporal trends in treatment-related outcomes surrounding a diabetic ketoacidosis (DKA) performance improvement intervention consisting of mandated intensive care unit admission and implementation of a standardized management pathway, and identifies physical and biochemical characteristics associated with outcomes in this population.

Methods: A retrospective cohort of 1225 children with DKA were identified in the electronic health record by international classification of diseases codes and a minimum pH less than 7.3 during hospitalization at a quaternary children's hospital between April, 2009 and May, 2016. Read More

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March 2018
2 Reads

Understanding Pre-Type 1 Diabetes: The Key to Prevention.

Front Endocrinol (Lausanne) 2018 6;9:70. Epub 2018 Mar 6.

Division of Endocrinology, Department of Pediatrics, University of Florida, Gainesville, FL, United States.

While the incidence of type 1 diabetes continues to rise by 3% each year, the ability to prevent this disease remains elusive. Hybrid closed loop devices, artificial pancreas systems, and continuous glucose monitoring technology have helped to ease the daily burden for many people living with type 1 diabetes. However, the artificial pancreas is not a cure; more research is needed to achieve our ultimate goal of preventing type 1 diabetes. Read More

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Neuroinflammation-Related Encephalopathy in an Infant Born Preterm Following Exposure to Maternal Diabetic Ketoacidosis.

J Pediatr 2018 Jun 16;197:286-291.e2. Epub 2018 Mar 16.

Alpert Medical School of Brown University, Providence, RI; Division of Neuropathology, Rhode Island Hospital, Providence, RI; Department of Pathology, Rhode Island Hospital, Providence, RI; Department of Neurology, Rhode Island Hospital, Providence, RI; Department of Neurosurgery, Rhode Island Hospital, Providence, RI. Electronic address:

A pregnant woman with new-onset type 1 diabetes and ketoacidosis delivered an infant at 28 weeks of gestation who died with multiple organ failure and severe cerebral vasculopathy with extensive hemorrhage, diffuse microgliosis, and edema. This illustrates that antenatal metabolic and inflammatory stressors may be associated with neonatal encephalopathy and cerebral hemorrhage. Read More

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June 2018
6 Reads

Supraventricular tachycardia as a complication of severe diabetic ketoacidosis in an adolescent with new-onset type 1 diabetes.

BMJ Case Rep 2018 Mar 15;2018. Epub 2018 Mar 15.

Department of Paediatrics and Child Health, Cork University Hospital Group, Cork, Ireland.

Diabetic ketoacidosis (DKA) is one of the most common causes of morbidity and mortality in new-onset type 1 diabetes (T1D). Supraventricular tachycardia (SVT), however, is a very rare complication of DKA. We present the case of a patient with new-onset T1D who presented with DKA. Read More

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March 2018
3 Reads

Thrombotic Thrombocytopenic Purpura in a Child with Diabetic Ketoacidosis.

Adv Biomed Res 2018 21;7:33. Epub 2018 Feb 21.

Metabolism Research Center, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Thrombotic thrombocytopenic purpura (TTP) secondary to diabetic ketoacidosis has been rarely reported and is considered as a rare complication. If left untreated, this condition could be life threatening with considerable morbidity and mortality. Herein, we report a 6-year-old girl with reduced consciousness and respiratory distress with a history of polydipsia and polyuria in the 2 weeks before hospitalization. Read More

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February 2018
1 Read

Racial/Ethnic Minority Youth With Recent-Onset Type 1 Diabetes Have Poor Prognostic Factors.

Diabetes Care 2018 05 1;41(5):1017-1024. Epub 2018 Mar 1.

Children's Mercy Kansas City, Kansas City, MO.

Objective: To compare races/ethnicities for characteristics, at type 1 diabetes diagnosis and during the first 3 years postdiagnosis, known to influence long-term health outcomes.

Research Design And Methods: We analyzed 927 Pediatric Diabetes Consortium (PDC) participants <19 years old (631 non-Hispanic white [NHW], 216 Hispanic, and 80 African American [AA]) diagnosed with type 1 diabetes and followed for a median of 3.0 years (interquartile range 2. Read More

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May 2018
3 Reads

Brain injury markers: S100 calcium-binding protein B, neuron-specific enolase and glial fibrillary acidic protein in children with diabetic ketoacidosis.

Pediatr Diabetes 2018 Feb 27. Epub 2018 Feb 27.

Department of Pediatric Endocrinology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.

Background: To investigate serum levels of brain injury markers in diabetic ketoacidosis (DKA) and the relation of these markers with clinical and radiological findings of brain injury and laboratory results.

Methods: Twenty-nine patients with DKA, 30 with type 1 diabetes mellitus (T1DM), and 35 healthy children were included. Clinical and laboratory findings, and the Glasgow Coma Scale (GCS) were recorded. Read More

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February 2018
10 Reads

Diabetic ketoacidosis incidence in children at first presentation of type 1 diabetes at an Australian regional hospital: The effect of health professional education.

Pediatr Diabetes 2018 Feb 27. Epub 2018 Feb 27.

Paediatric Unit, The Townsville Hospital, Townsville, Queensland, Australia.

Background: Diabetic ketoacidosis (DKA) is an acute life threatening, resource intensive preventable complication of type 1 diabetes which has major biopsychosocial effects on patients and families. Incidence of pediatric DKA has been studied nationally and internationally in metropolitan centers. This study analyzed the DKA incidence at first presentation of type 1 diabetes at Townsville Hospital, before and after an educational intervention. Read More

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February 2018
4 Reads

Electrocardiographic changes in children with diabetic ketoacidosis and ketosis.

Turk Pediatri Ars 2017 Dec 1;52(4):194-201. Epub 2017 Dec 1.

Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Intensive Care, Istanbul, Turkey.

Aim: We aimed to study electrocardiographic changes in children with diabetic ketoacidosis and ketosis and to evaluate the relation of the changes with serum electrolyte levels and ketosis.

Material And Methods: This study was performed in Istanbul Medical Faculty, Pediatric Emergency and Intensive Care Department between May 2008 and May 2009. The electrocardiographic parameters and QT length of children with diabetic ketoacidosis and ketosis were evaluated at diagnosis and after the treatment. Read More

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December 2017
1 Read

Predictors and Outcome of Acute Kidney Injury in Children with Diabetic Ketoacidosis.

Indian Pediatr 2018 Apr 9;55(4):311-314. Epub 2018 Feb 9.

Pediatric Emergency and Intensive Care Units, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Objective: To identify predictors and outcome of acute kidney injury (AKI) in children with diabetic ketoacidosis (DKA) admitted to a Pediatric Intensive Care Unit (PICU).

Methods: Retrospective case review of 79 children with DKA admitted between 2011-2014.

Results: Twenty eight children developed AKI during the hospital stay; 20 (71. Read More

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April 2018
2 Reads

Metabolic control and complications in Italian people with diabetes treated with continuous subcutaneous insulin infusion.

Nutr Metab Cardiovasc Dis 2018 Apr 9;28(4):335-342. Epub 2017 Dec 9.

Metabolic Diseases, Department of Medicine-DIMED, University of Padua, Padua, Italy. Electronic address:

Background And Aim: The objective of this cross-sectional study was to evaluate the degree of glycaemic control and the frequency of diabetic complications in Italian people with diabetes who were treated with continuous subcutaneous insulin infusion (CSII).

Methods And Results: Questionnaires investigating the organisation of diabetes care centres, individuals' clinical and metabolic features and pump technology and its management were sent to adult and paediatric diabetes centres that use CSII for treatment in Italy. Information on standard clinical variables, demographic data and acute and chronic diabetic complications was derived from local clinical management systems. Read More

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April 2018
3 Reads

Improving the Care of Youth With Type 1 Diabetes With a Novel Medical-Legal Community Intervention: The Diabetes Community Care Ambassador Program.

Diabetes Educ 2018 Apr 11;44(2):168-177. Epub 2018 Jan 11.

Division of Endocrinology & Diabetes, Department of Pediatrics, University of Washington, Seattle, Washington.

Purpose The purpose of this study was to examine the feasibility and efficacy of the Diabetes Community Care Ambassador (DCCA) Program, a novel medical-legal community intervention designed to support high-risk youth with type 1 diabetes. Methods Study eligibility criteria: ages 3-19 years, A1C ≥8.5% (≥69 mmol/mol) and/or recent diabetic ketoacidosis hospitalization, type 1 diabetes duration ≥1 year, and English- or Spanish-speaking. Read More

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April 2018
2 Reads

Fifteen-minute consultation: Insulin pumps for type 1 diabetes in children and young people.

Arch Dis Child Educ Pract Ed 2018 Jun 3;103(3):131-136. Epub 2018 Jan 3.

Department of Paediatric Endocrinology, Royal Hospital for Sick Children, Edinburgh, UK.

There is increasing worldwide use of continuous subcutaneous insulin infusions in paediatric type 1 diabetes (T1D), reflecting recent research outcomes and guidance, as well as families' wishes. Children/young people may present acutely with medical or surgical problems, in addition to issues related to T1D. This review provides general paediatricians with an introduction to pump therapy, highlighting common problems, management issues and when to seek specialist advice. Read More

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June 2018
2 Reads

Pediatric non-diabetic ketoacidosis: a case-series report.

BMC Pediatr 2017 Dec 19;17(1):209. Epub 2017 Dec 19.

Department of Endocrinology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Children Development and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing Key Labortory of Pediatrics, Chongqing, 400014, People's Republic of China.

Background: This study is to explore the clinical characteristics, laboratory diagnosis, and treatment outcomes in pediatric patients with non-diabetic ketoacidosis.

Methods: Retrospective patient chart review was performed between March 2009 to March 2015. Cases were included if they met the selection criteria for non-diabetic ketoacidosis, which were: 1) Age ≤ 18 years; 2) urine ketone positive ++ or >8. Read More

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December 2017
6 Reads

Elevated unmethylated and methylated insulin DNA are unique markers of A+β+ ketosis prone diabetes.

J Diabetes Complications 2018 Feb 31;32(2):193-195. Epub 2017 Oct 31.

Department of Medicine, Section of Diabetes and Endocrinology, Baylor College of Medicine, Houston, TX, USA. Electronic address:

A+β+ ketosis prone diabetes (KPD) is associated with slowly progressive autoimmune beta cell destruction. Plasma unmethylated and methylated insulin DNA (biomarkers of ongoing beta cell damage and systemic inflammation, respectively) were elevated in A+β+ KPD compared to all other KPD subgroups. Read More

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February 2018
2 Reads

Brugada phenocopy associated with diabetic ketoacidosis in two pediatric patients.

J Electrocardiol 2018 Mar - Apr;51(2):323-326. Epub 2017 Oct 28.

Division of Pediatric Cardiology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Box 631, Rochester, NY, USA. Electronic address:

Two patients without cardiac history demonstrated type 1 Brugada pattern during hospitalization for diabetic ketoacidosis (DKA). Both patients had normalization of their ECGs after treatment of marked electrolyte abnormalities and metabolic acidosis. In this report, we describe two cases of Brugada phenocopy associated with DKA in children. Read More

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October 2017
3 Reads

Potential Clinical Benefits of a Two-bag System for Fluid Management in Pediatric Intensive Care Unit Patients with Diabetic Ketoacidosis.

Pediatr Endocrinol Diabetes Metab 2017 ;23(1):6-13

Nassau University Medical Center, Department of Pediatrics, East Meadow, NY, USA.

Introduction: Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus (DM) that requires appropriate treatment with insulin and intravenous fluids. Both one-bag and two-bag systems of fluid management are used to treat pediatric diabetic ketoacidosis.

Aim Of The Study: We compare the one-bag and two-bag systems of fluid managementwith regard to incidence of hypoglycemia, serum bicarbonate correction, pH correction and discharge from the pediatric intensive care unit (PICU). Read More

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June 2018
3 Reads

A randomized controlled trial of one bag vs. two bag system of fluid delivery in children with diabetic ketoacidosis: Experience from a developing country.

J Crit Care 2018 Feb 22;43:340-345. Epub 2017 Sep 22.

Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.

Purpose: To compare one vs. two bag system with respect to blood glucose variability (BGV), time for resolution of acidosis and incidence of hypoglycemia, hypokalemia, and cerebral edema in children with diabetic ketoacidosis (DKA).

Material And Methods: In an open labelled randomized controlled trial, thirty consecutive patients ≤12years with DKA were randomized to either one (n=15) or two bag (n=15) system of intravenous fluid delivery. Read More

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February 2018
1 Read

Association of Insulin Pump Therapy vs Insulin Injection Therapy With Severe Hypoglycemia, Ketoacidosis, and Glycemic Control Among Children, Adolescents, and Young Adults With Type 1 Diabetes.

JAMA 2017 10;318(14):1358-1366

Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany.

Importance: Insulin pump therapy may improve metabolic control in young patients with type 1 diabetes, but the association with short-term diabetes complications is unclear.

Objective: To determine whether rates of severe hypoglycemia and diabetic ketoacidosis are lower with insulin pump therapy compared with insulin injection therapy in children, adolescents, and young adults with type 1 diabetes.

Design, Setting, And Participants: Population-based cohort study conducted between January 2011 and December 2015 in 446 diabetes centers participating in the Diabetes Prospective Follow-up Initiative in Germany, Austria, and Luxembourg. Read More

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October 2017
8 Reads

Effect of Metformin on Vascular Function in Children With Type 1 Diabetes: A 12-Month Randomized Controlled Trial.

J Clin Endocrinol Metab 2017 12;102(12):4448-4456

Discipline of Paediatrics, Robinson Research Institute, University of Adelaide, Australia.

Context: Children with type 1 diabetes have vascular dysfunction preceding atherosclerosis. Early interventions are needed to reduce cardiovascular disease.

Objective: To evaluate the effect of metformin on vascular function in children with type 1 diabetes. Read More

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December 2017
4 Reads

Factors Associated with C-peptide Levels after Diagnosis in Children with Type 1 Diabetes Mellitus.

Chonnam Med J 2017 Sep 25;53(3):216-222. Epub 2017 Sep 25.

Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea.

C-peptide is the best indicator of endogenous insulin secretion in patients with diabetes. This study investigated the relationship between C-peptide levels and clinical/laboratory parameters of children with type 1 diabetes mellitus (T1DM), as measured at 6-month intervals after diagnosis. We retrospectively reviewed the data of 34 children with newly diagnosed T1DM. Read More

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September 2017
5 Reads

Root Cause Analysis of Diabetic Ketoacidosis Admissions at a Tertiary Referral Pediatric Emergency Department in North India.

Indian J Endocrinol Metab 2017 Sep-Oct;21(5):710-714

Department of Pediatrics, Sri Ramachandra Medical College and Hospital, Chennai, Tamil Nadu, India.

Objectives: To identify system-based factors contributing to Emergency Department (ED) admissions of children with diabetic ketoacidosis (DKA) and related complications with emphasis on parental and physician awareness and prereferral management.

Materials And Methods: A prospective observational root cause analysis study of all consecutive admissions of children with DKA to pediatric ED of a tertiary care referral hospital in northern India over a period of 1 year (July 2010-June 2011). Prehospital, health-care system, referral, follow-up, and continuum of care related details were obtained through direct interview of parents and physicians and/or field observations for all enrolled children. Read More

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October 2017
3 Reads

In the setting of paediatric osteomyelitis do not be afraid to CAST an eye.

BMJ Case Rep 2017 Oct 4;2017. Epub 2017 Oct 4.

Paediatric Department, University Hospital Galway, Galway, Ireland.

The case commences with an innocuous right ankle injury (lateral malleolus), for which the patient, a 9-year-old boy, was placed in a temporary cast at his local hospital. Three days following this incident, the patient was diagnosed with new-onset type 1 diabetes mellitus. He was admitted to his local hospital with severe diabetic ketoacidosis appropriately treated and subsequently discharged c. Read More

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October 2017
8 Reads

A Collaborative In Situ Simulation-based Pediatric Readiness Improvement Program for Community Emergency Departments.

Acad Emerg Med 2018 Feb 13;25(2):177-185. Epub 2017 Nov 13.

Division of Pediatric Emergency Medicine, Yale University School of Medicine, New Haven, CT.

Background: More than 30 million children are cared for across 5,000 U.S. emergency departments (EDs) each year. Read More

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February 2018
3 Reads

Acute kidney injury in paediatric diabetic ketoacidosis: A missed opportunity?

J Paediatr Child Health 2017 Oct;53(10):1027

Department of Paediatrics, Austin Hospital, Melbourne.

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October 2017
1 Read

Diabetic Ketoacidosis with Extreme Hypernatremia in a 4-Year-Old Girl.

Indian J Crit Care Med 2017 Sep;21(9):610-612

Department of Pediatrics, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India.

A 4-year-old girl admitted with altered mental status, new-onset diabetes mellitus, and diabetic ketoacidosis (DKA) had a rapid rise in serum sodium from 158 mEq/L (corrected sodium 165 mEq/L) at the admission to 204 mEq/L within 18 hours of admission despite standard fluid and insulin therapy recommended for the treatment of DKA. During her illness, she developed arterial and deep vein thrombosis (DVT), bloodstream infection with Candida species, and extensive skin blistering and denudation. The child needed mechanical ventilation, insulin infusion, careful fluid titration to bring down the sodium gradually, and low-molecular weight heparin for her DVT. Read More

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September 2017
8 Reads

The Expression of Activating Receptor Gene of Natural Killer Cells () in Patients with 
Type 1 Diabetes Mellitus (T1DM).

Oman Med J 2017 Jul;32(4):316-321

Department of Clinical and Chemical Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.

Objectives: To identify the possible role of natural killer (NK) cells in the pathogenesis of type 1 diabetes mellitus (T1DM) through studying the expression of the gene, which encodes the NK cell activating receptor (NKG2E).

Methods: This study was conducted at Alexandria University Children's Hospital from April to October 2015. The study was conducted with 30 newly diagnosed T1DM patients (15 males and 15 females), aged 7-13 years (10. Read More

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July 2017
4 Reads

Screening for neonatal diabetes at day 5 of life using dried blood spot glucose measurement.

Diabetologia 2017 Nov 5;60(11):2168-2173. Epub 2017 Aug 5.

National Institute for Health Research (NIHR) Exeter Clinical Research Facility, University of Exeter, Exeter, UK.

Aims/hypothesis: The majority of infants with neonatal diabetes mellitus present with severe ketoacidosis at a median of 6 weeks. The treatment is very challenging and can result in severe neurological sequelae or death. The genetic defects that cause neonatal diabetes are present from birth. Read More

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November 2017
3 Reads

Diabetes Presentation in Infancy: High Risk of Diabetic Ketoacidosis.

Diabetes Care 2017 10 4;40(10):e147-e148. Epub 2017 Aug 4.

Section of Adult and Pediatric Endocrinology, Diabetes, and Metabolism, Department of Medicine, The University of Chicago, Chicago, IL

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October 2017
12 Reads

Nephrolithiasis: A complication of pediatric diabetic ketoacidosis.

Pediatr Diabetes 2018 03 24;19(2):329-332. Epub 2017 Jul 24.

The Warren Alpert Medical School of Brown University, Providence, Rhode Island.

Objective: To determine the frequency of nephrolithiasis as a complication of diabetic ketoacidosis (DKA) in pediatrics.

Methods: We performed a retrospective chart review of patients with DKA admitted to a pediatric hospital between January 2009 and July 2016. We identified patients with nephrolithiasis during admission for DKA. Read More

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March 2018
9 Reads

Clinical and Molecular Characterization of Children with Neonatal Diabetes Mellitus at a Tertiary Care Center in Northern India.

Indian Pediatr 2017 Jun;54(6):467-471

Division of Pediatric Endocrinology, Department of Pediatrics, AIIMS, New Delhi, and *Madras Diabetes Research Foundation, Chennai, India; and #Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK. Correspondence to: Prof. Vandana Jain, Division of Pediatric Endocrinology, Department of Pediatrics, AIIMS, Delhi-110 029, India.

Objective: To study the genetic mutations and clinical profile in children with neonatal diabetes mellitus.

Methods: Genetic evaluation, clinical management and follow-up of infants with neonatal diabetes.

Results: Eleven infants were studied of which eight had permanent neonatal diabetes. Read More

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June 2017
10 Reads

Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes Predicts Poor Long-term Glycemic Control.

Diabetes Care 2017 09 30;40(9):1249-1255. Epub 2017 Jun 30.

Department of Pediatrics, School of Medicine, University of Colorado, Aurora, CO

Objective: This study tested the hypothesis that diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes in children predicts poor long-term glycemic control independently of established risk factors.

Research Design And Methods: This was a prospective cohort study of 3,364 Colorado residents diagnosed with type 1 diabetes before 18 years of age, in 1998-2012, and monitored for up to 15 years. Of those, 1,297 (39%) had DKA at diagnosis (blood glucose >250 mg/dL, and venous pH <7. Read More

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September 2017
14 Reads

Adherence to a pediatric diabetic ketoacidosis protocol in children presenting to a tertiary care hospital.

Pediatr Diabetes 2018 03 30;19(2):333-338. Epub 2017 Jun 30.

Department of Pediatrics, University of British Columbia, Vancouver, Canada.

Objective: To review adherence to a provincial diabetic ketoacidosis (DKA) protocol and to assess factors associated with intravenous fluid administration and the length time on an insulin infusion.

Methods: A retrospective chart review was conducted of all DKA admissions to British Columbia Children's Hospital (BCCH) during September 2008 to December 2013. Data collection included diabetes history, estimation of dehydration, insulin and fluid infusion rates, and frequency of laboratory investigations. Read More

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March 2018
15 Reads

Ketoacidosis in Neonatal Diabetes Mellitus, Part of Wolcott-Rallison Syndrome.

Am J Case Rep 2017 Jun 27;18:719-722. Epub 2017 Jun 27.

Department of Pediatrics, Gayathri Pediatric and Maternity Center, Vijayawada, Andhra Pradesh, India.

BACKGROUND Neonatal diabetes mellitus is a rare condition and it is important to differentiate it from other causes, such as hyperglycemia in infancy, for better outcomes. We report a case of an infant who presented to our neonatal intensive care unit in ketoacidosis and a comatose state. CASE REPORT Our case was an infant who presented to the neonatal intensive care unit at 38 days of age in ketoacidosis. Read More

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June 2017
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Diabetes-Specific and General Life Stress and Glycemic Outcomes in Emerging Adults With Type 1 Diabetes: Is Race/Ethnicity a Moderator?

J Pediatr Psychol 2017 Oct;42(9):933-940

Department of Pediatrics, Baylor College of Medicine.

Objective: This study examines whether race/ethnicity moderates relationships of (a) diabetes stress and general life stressors with (b) diabetes outcomes of glycemic control and diabetic ketoacidosis (DKA) among emerging adults (aged 18-25 years) with type 1 diabetes (T1D).

Method: Using a T1D Exchange Registry sample of non-Hispanic White, African American, and Hispanic emerging adults (N = 3,440), multiple group analyses were used to determine whether race/ethnicity moderates the relationships between stress and diabetes outcomes.

Results: The relationships between the two stress types and glycemic control did not differ between African American and non-Hispanic Whites. Read More

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October 2017
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Markedly increased incidence of critical illness in adults with Type 1 diabetes.

Diabet Med 2017 10 12;34(10):1414-1420. Epub 2017 Jul 12.

Department of Internal Medicine, University of Manitoba, Winnipeg, Canada.

Aims: To compare the incidence of and mortality after intensive care unit admission in adults with paediatric-onset Type 1 diabetes vs the general population.

Methods: Using population-based administrative data from Manitoba, Canada, we identified 814 cases of paediatric-onset Type 1 diabetes, and 3579 general population controls matched on age, sex and region of residence. We estimated the incidence of intensive care unit admission in adulthood, and compared the findings between populations using incidence rate ratios and multivariable Cox proportional hazards regression, adjusting for age, sex, comorbidity and socio-economic status. Read More

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October 2017
3 Reads

Racial and ethnic differences among children with new-onset autoimmune Type 1 diabetes.

Diabet Med 2017 10 12;34(10):1435-1439. Epub 2017 Jul 12.

Section of Diabetes and Endocrinology, Department of Pediatrics, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, USA.

Aim: To compare demographic and clinical characteristics among children from ethnic minorities and non-Hispanic white children with new-onset autoimmune Type 1 diabetes.

Methods: We analysed a single-centre series of 712 children with new-onset autoimmune Type 1 diabetes between January 2008 and March 2011. The median (range) age was 9. Read More

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October 2017
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Thyroid function test in diabetic ketoacidosis.

Diabetes Metab Syndr 2017 Dec 15;11 Suppl 2:S623-S625. Epub 2017 Apr 15.

Department of Pediatrics Endocrinology and Metabolism, Ali Asghar Children's Hospital, Iran University of Medical Sciences, Tehran,Iran.

Background: Metabolism of thyroid hormones is influenced by acute systemic illnesses including diabetic ketoacidosis. In these cases T3 level is usually decreased and this condition is called "low T3 syndrome" which is usually reversed by treating the under lying Disease.

Objectives: thyroid function test analysis before and after diabetic ketoacidosis treatment. Read More

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December 2017
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Ketoacidosis at diagnosis of type 1 diabetes: Effect of prospective studies with newborn genetic screening and follow up of risk children.

Pediatr Diabetes 2018 03 23;19(2):314-319. Epub 2017 May 23.

Department of Pediatrics, MRC Oulu, PEDEGO Research Unit, University of Oulu and Oulu University Hospital, Oulu, Finland.

We studied the frequency of diabetic ketoacidosis (DKA) in children at diagnosis of type 1 diabetes (T1D) in a region where newborn infants have since 1995 been recruited for genetic screening for human leukocyte antigen (HLA)-conferred disease susceptibility and prospective follow up. The aim was to study whether participation in newborn screening and follow up affected the frequency of DKA, and to follow the time trends in DKA frequency. We first included children born in Oulu University Hospital since 1995 when the prospective studies have been ongoing and diagnosed with T1D <15 years by 2015 (study cohort 1, n = 517). Read More

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March 2018
1 Read