I imagine doctors in emergency departments and pediatric intensive care units will put this knowledge into effect immediately. The UC Davis researchers, led by Nicole Glaser, a pediatric endocrinologist and assistant professor of pediatrics, also found that children with diabetic ketoacidosis who have lower initial arterial carbon dioxide measurements and higher serum urea nitrogen concentrations are at increased risk for cerebral edema. When a child shows up at an emergency department with diabetic ketoacidosis, blood tests for carbon dioxide and urea nitrogen levels are routinely ordered. Until now, no one really knew who was at greatest risk for developing cerebral edema. The hope is that by knowing these risk factors, doctors will be able to better monitor the high-risk children, and pick up the initial signs of this complication before it progresses to a more serious stage.
Cerebral edema can lead to coma, neurological damage, and death.
In all, cerebral edema accounts for 50 percent to 60 percent of diabetes-related deaths in children. Caused by too little insulin in the body, diabetic ketoacidosis occurs mainly in patients with type I diabetes mellitus, also known as juvenile diabetes or insulin- dependent diabetes. Symptoms of ketoacidosis include unusual thirst, frequent urination, constant fatigue, dry or flushed skin, nausea and vomiting, labored breathing, confusion, and a fruity odor on the breath. The condition requires immediate emergency medical intervention. For 25 percent to 40 percent of children with new-onset type I diabetes, ketoacidosis is the first recognized sign of disease.