World Journal of
Pharmaceutical and Life Sciences

STUDY OF PRECIPITATING FACTORS OF DIABETIC KETOACIDOSIS AMONG TYPE I DIABETES MELLITUS CHILDREN

*Dr. Ahmed Fawzi Ibrahim Luhaibi, Dr. Muthana Dahham Mohammed and Dr. Mohammed Abdulrazzaq Mahmood

ABSTRACT

Diabetic ketoacidosis (DKA) is a common complication among children with diabetes mellitus (DM), and the risk of DKA in established type 1 diabetes mellitus is 1–10% per patient per year. This study aimed to determine the frequency of the precipitating factors of DKA admissions to emergency room in Amiriya general hospital – Al-Anbar/Iraq. This case-control study was conducted from January to December 2019 on 40 children with diabetic ketoacidosis (DKA) (19 males and 21 females; between 1 and 15 years of age) and 42 children with type 1 diabetes mellitus, as a control group (21 males and 21 females; between 1 and 15 years) who were admitted to Amiriya general hospital, Al-Anbar - Iraq. Data regarding history, full physical examination, and laboratory investigations (presence of glucose and/or ketones in urine, serum potassium (m.Eq/l), blood bicarbonate (mmol/L), venous pH, blood glucose (mg/dl), and the treatment given were recorded. The frequency of DKA was not significantly higher in girls than in boys 21(52.5%) vs. 19 (47.5%) (P > 0.05). In 22(55%) of cases, it was the first time they were discovered to be diabetic, and 10 (55.5%) of known diabetic patients had history of previous attacks of DKA and previous attacks of hypoglycemia were encountered in 15 (83.3%) of cases. The most common precipitating causes of DKA was infection, which occurred in 18 (45%) of the episodes, no identifiable cause for the episode was encountered in 10 (25%) of cases, missing the usual dose of insulin, and stress were identified in 6 (15%) for each, while increased food intake was documented as a precipitating factors in 2 (5%) of cases. Infection, missing the usual dose of insulin, stressful conditions and increased food intake were the main precipitating factors for DKA. Newly discovered DM presenting for the first time as DKA involved a significant proportion of the cases of DKA. It can be concluded that the main precipitating factors for the episodes were infections, missing the usual dose of insulin, infections, stressful conditions and increased food intake especially sweets. Newly discovered DM presenting for the first time as DKA were a significant proportion of the cases of DKA.

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