The Incidence of Cerebral Edema in Pediatric Diabetic Ketoacidosis

Abstract

Introduction: Cerebral edema is an uncommon but devastating consequence of diabetic ketoacidosis occurring more in children than adults. Younger children and those with newly diagnosed diabetes are at highest risk. The objective of this study is to determine the frequency of cerebral edema in pediatric diabetic ketoacidosis at Children’s Hospital, Lahore in children with type 1 diabetes mellitus.

Methods: This descriptive study was carried out in the pediatric intensive care units and medical wards of the Children’s Hospital and the institute of Child Health, Lahore from 2nd Feb 2016 to 2nd Aug 2016. A total of 150 patients fulfilling the inclusion criteria were enrolled. After taking consent from parents, demographic information including name, age, sex, address, and date of admission were recorded. Fundoscopic findings were recorded before initiating diabetic ketoacidosis treatment and neurological examination was conducted at presentation. Cerebral edema was labeled as per operational definition and sampling was done as per hospital DKA management protocol.

Results: In our study, out of 150 cases, 58.67%(n=88) were between 1-7 years of age while 41.33%(n=62) were between 8-14 years of age, mean + sd was calculated as 6.92+3.12 years, 51.33%(n=77) were male and 48.67%(n=73) were females. Frequency of cerebral edema in pediatric diabetic ketoacidosis at children’s hospital Lahore in the child with type 1 diabetes mellitus was calculated in 18.67%(n=28) while 81.33%(n=122) had no findings of cerebral edema.

Conclusions: Frequency of cerebral edema is high in pediatric diabetic ketoacidosis at Children’s Hospital Lahore in the child with type 1 diabetes mellitus.