Diabetic ketoacidosis in a pediatric patient. Case report

Authors

DOI:

https://doi.org/10.26871/killcanasalud.v9i1.1608

Keywords:

Diabetic Ketoacidosis, diabetes Mellitus type 1, preschool child, insulin, emergency medical services

Abstract

Diabetic ketoacidosis (DKA) is an acute and serious metabolic complication of type 1 diabetes, particularly common in pediatric patients. It occurs when there is an absolute or relative insulin deficiency along with an excess of counter-regulatory hormones, leading to hyperglycemia, metabolic acidosis, and ketonemia. This case report describes a 3-year-old male patient who presented to the emergency department with dehydration, irritability, abdominal pain, and weight loss, and was diagnosed with moderate DKA. Timely clinical management with fluid resuscitation and controlled insulin therapy led to successful stabilization and recovery. This case underscores the importance of early diagnosis and proper management, especially in settings with limited resources.

Downloads

Download data is not yet available.

References

Hofheinz SB, Villar Guerra P del, Cuesta AP. Cetoacidosis diabética. An Pediatria Contin. 2014; 12(2): 55–61. DOI: https://doi.org/10.1016/S1696-2818(14)70169-6

Calimag APP, Chlebek S, Lerma EV, et al. Diabetic ketoacidosis. Dis Mon. 2023; 69(3): 101418. DOI: https://doi.org/10.1016/j.disamonth.2022.101418

Dhatariya KK, Glaser NS, Codner E, et al. The management of diabetic ketoacidosis in adults-An updated guideline from the Joint British Diabetes Society for Inpatient Care. Diabetic ketoacidosis. 2022; 39(6): 1–20. DOI: https://doi.org/10.1111/dme.14788

Olivieri L, Chasm R. Diabetic Ketoacidosis in the Pediatric Emergency Department. Emerg Med Clin North Am. 2013; 31(3): 755–773. DOI: https://doi.org/10.1016/j.emc.2013.05.004

Céspedes C, Bustos C. Manejo de la cetoacidosis diabética en niños y adolescentes. Endocrinol Nutr. 2008; 55(7): 289–296. DOI: https://doi.org/10.1016/S1575-0922(08)72183-1

Tzimenatos L, Nigrovic LE. Managing Diabetic Ketoacidosis in Children. Ann Emerg Med. 2021; 78(3): 340–345. DOI: https://doi.org/10.1016/j.annemergmed.2021.02.028

Cashen K, Petersen T. Diabetic Ketoacidosis. Pediatr Rev. 2019; 40(8): 412–420. DOI: https://doi.org/10.1542/pir.2018-0231

DePiero A, Kuppermann N, Brown KM, et al. Hypertension during Diabetic Ketoacidosis in Children. J Pediatr. 2020; 223: 156-163.e5. DOI: https://doi.org/10.1016/j.jpeds.2020.04.066

Hamtzany O, Weiser G, Heiman E, et al. Leukocytosis and C-Reactive Protein Levels as Indicators of Infection in Children With Diabetic Ketoacidosis. Pediatr Emerg Care. 2023; 39(11): 828–831. DOI: https://doi.org/10.1097/PEC.0000000000002934

Freeman JN, Giroux C, King T, et al. Variations in Management and Clinical Outcomes for Children With Diabetic Ketoacidosis in an Academic Pediatric Versus Community Emergency Department Setting. Pediatr Emerg Care. 2024; 40(8): e133–e138. DOI: https://doi.org/10.1097/PEC.0000000000003197

Rewers A, Kuppermann N, Stoner MJ, et al. Effects of Fluid Rehydration Strategy on Correction of Acidosis and Electrolyte Abnormalities in Children With Diabetic Ketoacidosis. Diabetes Care. 2021; 44(9): 2061–2068. DOI: https://doi.org/10.2337/dc20-3113

EL-Mohandes N, Yee G, Bhutta BS, Huecker MR. Pediatric Diabetic Ketoacidosis. 2023 Aug 21. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 29262031. Available in: https://www.ncbi.nlm.nih.gov/books/NBK470282/

Dhatariya KK, Glases N, Codner E, Umpierrez G. Diabetic ketoacidosis. Nat Rev Dis Primers. 2020; 40. DOI: https://doi.org/10.1038/s41572-020-0165-1

Wardi G, Holgren S, Gupta A, Pearce A, Malhotra A, et al. A Review of Bicarbonate Use in Common Clinical Scenarios. J Emerg Med. 2023; 65(2): e71–e80. DOI: https://doi.org/10.1016/j.jemermed.2023.04.012

Sanluis Fenelli G, Bechara Aded C, Lagger J, Widmer J, et al. Incidencia de Hipofosfatemia en niños con cetoacidosis diabética y tratamiento con insulina regular subcutánea. Estudio observacional. Andes Pediatr Rev Chil Pediatr. 2024; 95(2): 183–189. DOI: https://doi.org/10.32641/andespediatr.v95i2.4924

Kamrath C, Mönkemöller K, Biester T, et al. Ketoacidosis in Children and Adolescents With Newly Diagnosed Type 1 Diabetes During the COVID-19 Pandemic in Germany. JAMA 2020; 324(8): 801–804. DOI: https://doi.org/10.1001/jama.2020.13445

Rivero-Martín MJ, Rivas-Mercado CM, Ceñal-González-Fierro MJ, et al. Severity of new-onset type 1 diabetes in children and adolescents during the coronavirus-19 disease pandemic. Endocrinol Diabetes Nutr. 2022; 69(10): 810–815. DOI: https://doi.org/10.1016/j.endien.2021.12.014

Zamora M, Huerta A, Jiménez E, Neira D. Criterio clínico y complicaciones en pacientes con cetoacidosis diabética. 2021; 7(6): 1337-1353. 7. DOI: https://doi.org/10.23857/dc.v7i6.2397

Choi AY, Park E. The impact of pediatric intensivists on the management of pediatric diabetic ketoacidosis in pediatric intensive care units. BMC Pediatr. 2023; 23: 562. DOI: https://doi.org/10.1186/s12887-023-04398-z

Published

2025-01-15
ESTADISTICAS
  • Abstract 0
  • PDF (Español (España)) 0
  • HTML (Español (España)) 0

How to Cite

Benítez Díaz, M. I., Duque Sánchez, E. P. ., Altamirano Alvarado, F. J. ., Paguay Morejón, M. G. ., García Pulla, S. E. ., & Yuquilema Valente, R. P. . (2025). Diabetic ketoacidosis in a pediatric patient. Case report. Killkana Salud Y Bienestar, 9(1), 77–89. https://doi.org/10.26871/killcanasalud.v9i1.1608