Successful medical management of diabetic ketoacidosis at first presentation in a child with type 1 diabetes: A case report

• Published in: Annals of medicine and surgery 2022-07, Vol.79, Article 103981
• Main Authors: Sharma, Shriya, Adhikari, Aakriti, Adhikari, Samikshya, Poudel, Sabin, Bk, Reshu, Mainali, Gaurab, Yadav, Sumit Kumar
• Format: Article
• Language: English
• Subjects: Case Report; Child; Diabetic ketoacidosis; Insulin; Type 1 diabetes mellitus
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1016/j.amsu.2022.103981

Diabetic ketoacidosis (DKA) is considered to be a common presentation of type 1 diabetes mellitus in children. It occurs when absolute or relative insulin insufficiency prevents glucose from entering the cells for use as metabolic fuel, causing the liver to quickly break down fat into ketones for use as fuel source. As a result, ketones are overproduced, accumulating in the blood and urine making the blood acidic. A 4 years and 8 months old child presented with the complaint of abdominal pain and vomiting along with polyurea, polydipsia and polyphagia. Routine examination of blood revealed that increased random blood glucose level. Once diagnosed, DKA was managed with fluid and insulin therapy with close monitoring and supervision. DKA can be easily diagnosed. Proper management should be done on time to prevent complications like hypokalemia, hyponatremia leading to cerebral edema and shock. Diabetic awareness programs and school educational tutorials are beneficial for community awareness of the signs and symptoms of diabetes. •Diabetic ketoacidosis (DKA) is considered to be a common presentation of type 1 diabetes mellitus in children.•Severe fall in insulin levels leads to increase in lipolysis which will lead to increase in level of ketone bodies resulting metabolic acidosis and compensatory respiratory alkalosis.•DKA is diagnoses on the basis of hyperglycemia, metabolic acidosis and ketonuria and severity is categorized on the basis of acid-base status.•Early medical management and close monitoring could prevent complications like cerebral edema, mental confusion, shock and death.