Background: Diabetic ketoacidosis (DKA) is a common, life-threatening complication of type 1 diabetes (T1D). Insulin deficiency impairs lipoprotein lipase (LPL) resulting in elevated serum triglycerides (TG) that usually normalize after establishing IV insulin.
Objectives: To study the prevalence of hypertriglyceridemia during DKA in T1D patients and assess its relation to DKA severity and glycemic control after 3 months.
Methodology: This cohort study included 84 children with T1D presenting with DKA at the Diabetes, Endocrine and Metabolism Pediatric Unit (DEMPU), Cairo University. Patients were evaluated for serum TG on admission and 48 h after initiating insulin therapy. HbA1c was assessed 3 months later.
Results: In our cohort, 74 patients (88.1%) had hypertriglyceridemia at onset of DKA that resolved in 41 of them after 48 h, while 33 patients still had hypertriglyceridemia. There was significant improvement in TG after 48 h of DKA management (P<0.001). When basal serum TG was correlated with other study parameters, a significant positive correlation was found with BG (P=0.005) and duration of ICU stay (P<0.001), while a significant negative correlation was found with serum bicarbonate and GCS (i.e. conscious level) with a P value of 0.012 & 0.022 respectively. No significant correlation was found between TG (basal & after 48 h) and glycemic control or insulin requirements after 3 months.
Conclusion: Hypertriglyceridemia was detected in most patients of T1D during DKA that significantly improved with insulin therapy. TG correlated with the DKA severity and BG levels. However, it did not affect glycemic control or insulin dose later.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology