Characteristics of children with diabetic ketoacidosis treated in the intensive care unit through 10 years: a retrospective study

Dijabetična ketoacidoza (DKA) je akutna, po život opasna komplikacija šećerne bolesti. Cilj: cilj ovog diplomskog rada je utvrditi demografske podatke, klinička obilježja i laboratorijske parametre bolesnika koji su zbog razvoja DKA zahtijevali intenzivno liječenje. Materijali i metode: retrospektivno je analizirana medicinska dokumentacija 58 djece u razdoblju od 1. siječnja 2011. do 31. prosinca 2020. na Odjelu za intenzivno liječenje djece KBC-a Rijeka. Rezultati: udio bolesnika s DKA među bolesnicima s novootkrivenom šećernom bolesti tip 1 u ovom istraživanju iznosi 26%. U 83% hospitaliziranih bolesnika DKA je bila inicijalna prezentacija šećerne bolesti tip 1. 91% ispitanika imalo je samo jednu epizodu DKA. Najveći udio bolesnika (39%) prezentirao se teškom DKA. Poliurija, polidipsija i povraćanje tri su najčešća simptoma ispitanika ove studije. 69% bolesnika pri prijemu u bolnicu bilo je umjereno teško ili teško dehidrirano. Edem mozga kao komplikaciju DKA razvilo je četvero bolesnika od kojih je jedan završio smrtnim ishodom. Zaključak: potrebna je dobra edukacija opće populacije, bolesnika i obitelji oboljelih od šećerne bolesti kako bi se prevenirao razvoj DKA i tako smanjila njezina incidencija.Diabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes. Aim: the aim of this graduate thesis is to determine demographic data, clinical features and laboratory parameters of patients who required intensive treatment due to the development of DKA. Materials and methods: the medical documentation of 58 children hospitalized at the Department of Intensive Care of Children of the Clinical Hospital Center Rijeka in the period from January 1, 2011 to December 31 2020 was retrospectively analyzed. Results: the proportion of patients with DKA among patients with newly diagnosed type 1 diabetes in this study is 26%. In 83% of hospitalized patients DKA was an initial presentation of type 1 diabetes. 91% of patients had only one episode of DKA. The largest proportion of patients (39%) presented with severe DKA. Polyuria, polydipsia, and vomiting are the three most common symptoms of patients in this study. 69% of patients were moderate or severely dehydrated prior to hospital admission. Four patients developed cerebral edema as a complication of DKA, one of whom died. Conclusion: good education of the general population, patients and families of diabetics is needed in order to prevent the development of DKA and thus reduce its incidence