A case report on diabetic ketoacidosis in 5 years old female child

Tejaswi Chillara, Gunisetti Tejaswini, Goparaju Kavya, Mattewada Hima Bindhu
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Abstract

Diabetic ketoacidosis is characterised by an insulin deficiency, metabolic acidosis and increased ketone concentration in the body which can be normalised by insulin replacement and electrolyte replacement therapy. One in three children suffers with type 1 diabetes (T1D), across the US and globally, the incidence of the disease is rising among the paediatrics by over 3% annually. The diagnosis of diabetic ketoacidosis (DKA) was based on the presence of hyperglycaemia (blood glucose > 11 mmol/L), acidosis (serum bicarbonate < 15 mmol/L) and ketonuria (urine ketone ≥1+). Gestational diabetes is a common abnormality of glucose metabolism during pregnancy which affects foetal development and an alteration in the balance of glucagon and insulin is affected due to an overproduction of glucose and ketones in the liver, with free release of fatty acids from adipose tissue. A case of 5 years old female child presented with increased urination, increased appetite and sudden weight loss since 1 month and her RBS range was found to be 426mg/dl. Child underwent laboratory investigations, GRBS monitoring every 3 and assessed as Diabetic ketoacidosis with uncontrolled sugars. The child was treated with insulin supplementation for 3 days, recovered and child was hemodynamically stable and got discharged.
5 岁女童糖尿病酮症酸中毒病例报告
糖尿病酮症酸中毒的特征是胰岛素缺乏、代谢性酸中毒和体内酮体浓度升高。在美国和全球范围内,每三名儿童中就有一名患有 1 型糖尿病(T1D),儿科发病率每年以超过 3% 的速度上升。糖尿病酮症酸中毒(DKA)的诊断依据是高血糖(血糖 > 11 mmol/L)、酸中毒(血清碳酸氢盐 < 15 mmol/L)和酮尿(尿酮≥1+)。妊娠糖尿病是一种常见的妊娠期糖代谢异常,会影响胎儿的发育,由于肝脏中葡萄糖和酮体的过度生成,以及脂肪组织中脂肪酸的游离释放,会影响胰高血糖素和胰岛素的平衡。一例 5 岁的女婴自 1 个月起出现排尿增多、食欲增加和体重骤减的症状,RBS 值为 426 毫克/分升。患儿接受了实验室检查,每 3 天接受一次血糖监测,结果被评估为糖尿病酮症酸中毒,糖分失控。患儿接受了为期 3 天的胰岛素补充治疗,病情得到恢复,血流动力学稳定,可以出院。
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