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Abstract Ref Number = APCP835
Poster Presentation
TIME CHALLENGING - EARLY DIAGNOSIS AND PROMPT TREATMENT OF YOUNGER SEVERE PEDIATRIC DIABETIC KETOACIDOSIS (DKA)
FISAURA UNSA,NADIYYA FAZA ZHAFIRAH,MARTINUS M LEMAN,BINA AKURA RS HARAPAN BUNDA
Background : Diabetic ketoacidosis (DKA) is a common acute crisis of type-1 diabetes mellitus (T1DM). As a result of insulin deficiency, DKA often manifests as hyperglycemia, ketosis and metabolic acidosis. We report a rare case of a 4-year-old boy with DKA, younger than average age of first DKA episodes, as his first clinical manifestation of T1DM. We aim to identify key symptoms and signs in DKA so that prompt treatment may be initiated to prevent severe complication of DKA. Case Presentation Summary : Patient was admitted due to breathing difficulty, productive cough, vomiting, polyuria, polydipsia and dramatic weight loss in the past of few days. He was lethargic and initial blood glucose test result was 691 mg/dL. Evidences of severe ketoacidosis condition were arterial pH of 6.982; serum bicarbonate level of 1.9 mmol/L; and qualitative blood ketones of +3. Intravenous fluid and continuous regular insulin infusion was started. He was discharged after 9 days of hospitalization. He was later switched to subcutaneous regular insulin therapy as well as periodical self-glucose monitoring. Learning Points/Discussion : Preventing delay in detection of DKA symptoms is a time challenging issue and critical to reduce harm and increase level treatment success. Physician and pediatrician should be alerted to make early clinical judgment, distinguishing from common pediatric of infection and perform treatment guidelines of pediatric DKA to prevent severe complication due to prolonged metabolic acidosis.
Keywords: pediatric type-1 diabetes mellitus diabetic ketoacidosis
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