ESPE Abstracts

Introduction: Diabetic Ketoacidosis (DKA) is one of the acute complications of type 1 diabetes. It is a life-threatening condition that varies in severity and prognosis from patient to another. In Egypt, there is no available data about the socio-demographic characteristics as well as the DKA severity determinants among children

Objective: 1. To identify demographic, clinical and laboratory variables of pediatric patients diagnosed with DKA at Suez Canal university medical center through three years; 2. To identify the determinants of DKA severity among Egyptian children.

Methods: We conducted a retrospective study from medical records of children and adolescents presented with DKA at emergency department of a Suez Canal university pediatric hospital between 2014 and 2016. DKA severity was categorized as mild, moderate, or severe. Data collected obtained demographic, clinical and laboratory variables. Multivariate regression analysis was applied to identify determinants for of DKA severity.

Results: From a total of 86 DKA patients, Females (61.6%) were almost twice number of males (38.4%). one-third of patients (31.4%) have a positive family history of diabetes. More than 65% were newly diagnosed to have type 1 DM at admission. The most frequently presented symptoms at admission were vomiting, polyuria, and abdominal pain. mean HbA1c was 10.6±2.24 and mean random blood sugar at admission was 431±108 mg/dl. Blood gases parameters at presentation showed that mean pH was 7.18±0.15 and mean bicarbonate was 11.04±4.5. mean sodium and potassium levels were 136±10.5 and 3.9±0.68, respectively. Regarding symptoms, vomiting presentation was found to be significantly different among grades of DKA (P=0.041). There were also statistically significant differences in HbA1c (P=0.019), pH (P<0.01), bicarbonate (P<0.01), and sodium level (P=0.02) among different grades of DKA. Multivariate analysis showed that DKA severity isn’t associated with any of demographic, clinical or laboratory variables.

Conclusion: Although we couldn’t find potential determinants of DKA severity in our sample; vomiting, serum sodium, and HbA1c can be possible predictors for further wide-scale study.