Ketoacidosis In Tunisian Children

Background: Diabetic ketoacidosis (DKA) is a life-threatening acute metabolic complication occurring in children with type 1 diabetes, due to an insulin deficiency.

Objectives: Describe the epidemiological, clinical, biological, therapeutic and evolutives modalities of DKA in tunisian children.

Methods: This was a retrospective study including all pediatric patients with DKA admitted to pediatric emergency department Sahloul Hospital Souse Tunisia between January 2017 to december 2018. Epidemiological, clinical, biological, therapeutic and evolutives parameters were analyzed.

Results: 50 DKA were collected in children aged between 3 to 15 years with an average at 9. There is no sex predominance (sex ratio = 1.1). 58% of children had a family history of diabetes. The polyuro-polydipsic syndrome was the revealing symptom in 100% of cases followed by digestive signs including abdominal pain in 60% of cases. The DKA was inaugural in 76% of cases. Decompensation factors were mainly infectious causes (70%), followed by poor compliance in 11% of cases. On admission, dehydration was almost constant. The collapse was found in 20 children. The acidosis polypnea was reported 41% of cases. Consciousness disorders were found in 10 cases. On the biological level, the average blood glucose level was 27mmol / l. The corrected natremia averaged 137mmol / l with extreme values ​​ranging from 129mmol / to 146. Potassium rate was low in 60% of cases. The ISPAD recommandations were applied in all cases. The evolution was favorable in 49 cases. One case of cerebral oedema were noted.

Conclusion: DKA remains a serious complication of childhood diabetes in tunisien children. The most effective strategy was prevention.