ESPE Abstracts (2019) 92 P3-93

Diabetes and Insulin

Severe and Inaugural Diabetic Ketoacidosis in Children: Experience of a Pediatric Tunisian Department

asma guedria, Zouhour Hadrich


Faculty of Medicine of Tunis, Tunis, Tunisia


Introduction: Ketoacidosis is often indicative of diabetes in children in our Tunisian context. It can be severe and life-threatening, with mortality in the order of 1 to 2%.

Methods: We report the results of a retrospective study over a period of 2 years (from 1/01/2017 to 31/12/2018) on all cases of inaugural ketoacidosis of type 1 diabetes mellitus in children, collected at the pediatric department of Mohamed Tlatli hospital in Tunisia.

Findings: During this period, 10 cases of ketoacidosis decompensation were identified. The average age was 6.16 years, with male sex predominating (sex ratio= 4). The ketoacidosis decompensation was inaugural in all cases.

Four of the admitted diabetic children had presented a severe ketoacidosis decompensation.

The clinical features were dominated by polyuropolydipsic syndrome present in 9 cases two weeks to one month before decompensation, dehydration was almost constant with collapse found in 2 cases, polypnea translating acidosis observed in 6 cases, the state of consciousness was altered in 3 cases.

Biologically: mean blood sugar was 24.39 mmol / l, mean alkaline reserve was 6.64 and renal function was disrupted in 7 cases.

All patients were perfused for an average duration of 23.3 hours with extremes ranging from 15 hours to 41 hours.

The evolution was favorable in all cases.

Conclusion: Severe diabetic ketoacidosis remains frequent and life-threatening for young patients, while the diagnosis of early childhood diabetes is easy, immediate and inexpensive. The challenge is to reduce the frequency of ketoacidosis as a revealing circumstance of diabetes in children, by bringing the diagnosis to an earlier stage of the disease

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