Clinical and evolutionary aspects of diabetic ketoacidosis in children in a general pediatric ward in Tunisia: Study of 44 cases

Abstract

Diabetic ketoacidosis (DKA) is a life-threatening emergency requiring appropriate and urgent management. The aim of this study was to describe the epidemiological, clinical, therapeutic and evolutionary characteristics of children admitted to the pediatrics and neonatology department of Bizerte University Hospital for DKA. This was a retrospective study spanning five years from January 1, 2018 to December 31, 2022. We included 44 cases of ACD, 68% of which were inaugural. The mean age was 9±2 years, with a female predominance (gender-ratio=0.4). Initial symptoms were dominated by a polyuro-polydipsic syndrome, asthenia, abdominal pain and vomiting. Mean pH and bicarbonate values were 7.17±0.14 and 8.6±0.2 mmol/l respectively. ACD was classified as moderate in 17 cases (38%). Severe forms were more frequent in patients over 4 years of age. Patients were managed according to the ISPAD protocol; the average duration of the protocol was 24 h, with good clinical and biological evolution.