Diabetic ketoacidosis in children and adolescents: Diagnostic and Therapeutic Pitfalls

A new study by Eirini Kostopoulou and team showed that in potentially deadly medical emergency, Diabetic ketoacidosis (DKA), accurate and speedy diagnosis, early management, and careful monitoring are crucial for breaking the cycle of life-threatening episodes and preventing serious sequelae in children and adolescents. The findings of this study were published in Diagnostics.

DKA is a common manifestation of Type 1 Diabetes Mellitus (T1DM) and, less frequently, Type 2 Diabetes Mellitus (T2DM) in children and adolescents. It is an immediate, severe consequence of relative insulin insufficiency. Acidemia, hyperglycemia, and/or ketonuria are the biochemical triads that describe it. Any physiological stress, including infections, can induce DKA, with gastroenteritis and urinary tract infections being the most common triggers. The current study seeks to increase knowledge of diagnostic and therapeutic pitfalls that make the best diagnostic and therapeutic response to this pediatric emergency fairly difficult, as well as a high index of suspicion surrounding them.

The Pubmed/Medline and Scopus databases, which include publications published from 2000 onwards, were used to perform a review of the literature. Differentiating between T1DM and T2DM, DKA and hyperosmolar hyperglycemic state (HHS), and DKA and alternative diagnoses presenting with overlapping symptoms, such as pneumonia, urinary tract infection, asthma exacerbation, acute abdomen, gastroenteritis, and central nervous system infection, are among the diagnostic challenges.