The treatment of children in diabetic ketoacidosis
Posted on February 8, 2010
Filed Under Ketoacidosis | 2 Comments
Children’s Hospital of Pittsburgh Sperling, a consensus of physicians, etc. The report notes that the American Diabetes Association (ADA) recently released proposed guidelines, children with diabetic ketoacidosis (DKA) as different from adult clinical performance and, therefore, requires different treatment methods .
Dr. Sperling said that this guide is the ADA’s first guidelines on the management of children in DKA, its content and management of adult DKA and non-ketotic hyperglycemic coma guide different, indicating ADA has recognized that children are not small adults, they have a special needs. Very young children with a history of diabetes difficult to collect, often misdiagnosed as pneumonia or other diseases, so doctors of any children of unknown etiology should be thought of the possibility of diabetes.
Dr. Sperling was also pointed out that children and adults, metabolic rate and body surface area were different, in the treatment of DKA in the process need to be more careful to correct children’s water and electrolyte metabolism imbalance. Very young children’s brains and other self-regulatory function have yet to develop comprehensive, must pay special attention to the occurrence of cerebral edema, which is the most common cause of death in children with DKA (incidence of 0.5% ~ 1%). In all survival after onset of DKA in children, about a quarter of the existence of permanent nerve injury. The guide also emphasized that delay in the diagnosis of diabetes is the main reason for children DKA, while the leakage of insulin use is the leading cause of recurrence of juvenile DKA.
Early identification of symptoms of juvenile diabetes, and metabolic decompensation in children with DKA prior to the implementation of treatment is feasible. Medical staff and the public, particularly school and kindergarten teachers should recognize that: Children I incidence of diabetes increasing in children as early as possible in case of suspicious to the doctor consultation. The physicians in the diagnosis and treatment of pediatric patients should also give more consideration to the possibility of diabetes.
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