DIABETIC KETOACIDOSIS IN PEDIATRICPATIENTS: A 10-YEAR RETROSPECTIVE STUDY COMPARING PREVIOUSLY DIAGNOSED AND NEWLY DIAGNOSED CASES AT PRESENTATION
Authors:   Pediatric Intensive Care Unit, Mother and Child Hospital, Mohammed VI University Hospital Center of Marrakech, Morocco., El Fehmi Lamia ,   Faculty of Medicine and Pharmacy, Cadi Ayyad University Marrakech, Morocco.,   Childhood Health and Development Research Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University Marrakech, Morocco., Merbouh Manal ,   Pediatric Intensive Care Unit, Mother and Child Hospital, Mohammed VI University Hospital Center of Marrakech, Morocco.,   Faculty of Medicine and Pharmacy, Cadi Ayyad University Marrakech, Morocco.,   Childhood Health and Development Research Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University Marrakech, Morocco., Sarhaoui Houssameddine ,   Pediatric Intensive Care Unit, Mother and Child Hospital, Mohammed VI University Hospital Center of Marrakech, Morocco.,   Faculty of Medicine and Pharmacy, Cadi Ayyad University Marrakech, Morocco.,   Childhood Health and Development Research Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University Marrakech, Morocco., Mouaffak Youssef ,   Pediatric Intensive Care Unit, Mother and Child Hospital, Mohammed VI University Hospital Center of Marrakech, Morocco.,   Faculty of Medicine and Pharmacy, Cadi Ayyad University Marrakech, Morocco.,   Childhood Health and Development Research Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University Marrakech, Morocco., Younous Said ,   Pediatric Intensive Care Unit, Mother and Child Hospital, Mohammed VI University Hospital Center of Marrakech, Morocco.,   Faculty of Medicine and Pharmacy, Cadi Ayyad University Marrakech, Morocco.,   Childhood Health and Development Research Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University Marrakech, Morocco.
Published: February 2025

Background:Diabetic ketoacidosis (DKA) represents a severe metabolic disorder associated with diabetes mellitus (DM), posing a heightened risk of morbidity and mortality in children. This research aims to evaluate the prevalence of DKA in pediatric patients and to explore its clinical characteristics and biological consequences during intensive care management.

Patients and Methods: A retrospective study was carried out on children younger than 15 years who were hospitalized for DKA in the pediatric intensive care unit of Mohammed VI University Hospital, Marrakech, Morocco, spanning the period from January 2010 to December 2020. A comparative analysis was performed between two groups: patients with a known history of diabetes and those experiencing DKA as the initial presentation of diabetes.

Results:Over a 10-year period, 240 cases of DKA were identified among 8,222 admissions, representing 2.91% of total admissions. The mean age of patients was 7.49 Â± 4.44 years, with a higher prevalence observed in children over 10 years old. The most common clinical signs included polyuria-polydipsia syndrome, Kussmaul breathing, vomiting, and altered consciousness. The most severe symptoms were observed in children with newly diagnosed type 1 diabetes mellitus (T1DM). The majority of patients had a favourable outcome. However, 20.6% of cases experienced complications, and one death was recorded.

Discussion:This study highlights the significant burden of DKA in pediatric patients, especially among those newly diagnosed with T1DM. The high prevalence of infections as a triggering factor emphasizes the need for improved infection management in diabetic children. Prompt recognition and appropriate management play a key role in mitigating the morbidity and mortality linked to DKA.

Conclusion:DKA remains a severe complication of pediatric diabetes, with significant risks of serious consequences. Raising awareness among healthcare providers, facilitating early detection, and adopting a comprehensive approach to management are fundamental for enhancing clinical outcomes and minimizing complications.