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Diabetic Ketoacidosis

In children under 10 years of age, diabetic ketoacidosis causes 70% of diabetes-related deaths. The incidence of diabetes is 27.6 per 1,000. Defined by the triad of hyperglycemia, acidosis, and ketosis.

Clinical Presentation

Diabetes is newly diagnosed in 20% of cases. The remainder of cases occur in known diabetics in whom ketosis develops because of a precipitating factor, such as infection or noncompliance

Symptoms of diabetic ketoacidosis include polyuria, polydipsia, fatigue, nausea, and vomiting, developing over 1 to 2 days.

Patients are typically flushed, tachycardic, and tachypneic. Kussmaul's respiration, with deep breathing and air hunger, occurs when the serum pH is between 7.0 and 7.24.

A fruity odor on the breath indicates the presence.

Fever is seldom present even though infection is common. Hypothermia and hypotension may also occur. Eighty percent of patients have altered mental status.

Treatment