Çocuklarda Endokrinolojik Aciller Serisi 1 Diyabetik Ketoasidoz

Tip 1 diyabetin akut, ciddi bir metabolik komplikasyonu olan ve insülin yetersizliği temelinde insülin karşıtı hormonların artmış etkilerine bağlı olarak oluşan diyabetik ketoasidoz DKA özellikle tip 1 diyabetli çocuklarda sıkça karşılaşılan bir durumdur 1-5 . Tip 1 diyabetli hastaların %15-67'sinde ilk tanı sırasında DKA mevcuttur. Önceden tanı konmuş hastalarda hastaneye yatışı gerektiren DKA ataklarının oranı yılda hasta başına ~%1-10'dur. Ayrıca, tanı sırasında tip 2 diyabetli pediatrik olguların %33'ü ketonüriye ve %5-10'u da diyabetik ketoasidoza sahiptir. Diyabetle ilgilenen sağlık ekibi sayısının artmasıyla sıklığında son zamanlarda azalma olduğu dikkat çekmektedir 1-10 .

PDF

___

1. Baker DJ., Drash AL., and Escobar O. Diabetic Ketoacidosis. In: Fima Lifshitz (ed). Pediatric Endocrinology. Fourth Edition. New York: Marcel Deccer Inc.; 2003. pp 669-82.
2. Dunger DB, Sperling MA, Acerini CL, Bohn DJ, Daneman D, Danne TPA, Glaser NS, and et al. ESPE/LWPES consensus statement on diabetic ketoacidosis in children and adolescents. Arch. Dis. Child 2004; 89:88-194.
3. Kaufman F. Çocuklarda Diyabetik ketoasidoz. In: Lebovitz HE (Ed).Diabetes Mellitus ve ‹lgili Sorunlar›n Tedavisi. (Türkçe Çevirisi; Halil Saglam, Çeviri Editörü ‹lhan Satman) Dördüncü Bask›. ‹stanbul: Sigma Publishing Dan›flmanl›k & Organizasyon D›fl Tic. Ltd. fiti.; 2005. pp 60-8.
4. Sperling MA: Diabetic ketoacidosis. Pediatr Clin North Am 1984; 31:591-610.
5. Rosenbloom AL, Hanas R: Diabetic ketoacidosis (DKA): treatment guidelines. Clin Pediatr1990; 35:261-66.
6. Felner EI, White PC: Improving management of diabetic ketoacidosis in children. Pediatrics 2001; 108:735-740.
7. Levy-Marchal C, et al. Clinical and laboratory features of type 1 diabetic children at the time of diagnosis. Diabet Med 1992; 9:279-84.
8. Komulainen J, et al. Ketoacidosis at the diagnosis of type 1 (insulin dependent) diabetes mellitus is related to poor residual beta cell function. Childhood Diabetes in Finland Study Group. Arch Dis Child 1996; 75:410-15.
9. Curtis JR, et al. Recent trends in hospitalization for diabetic ketoacidosis in Ontario children. Diabetes Care 2002; 25:1591-6.
10. Hirasing RA, et al. Trends in hospital admissions among children aged 0-19 years with type I diabetes in the Netherlands. Diabetes Care 1996;19:431-4.
11. Levitsky L, et al. Death from diabetes (DM) in hospitalized children (1970-1988). Pediatr Res 1991; 29:A195 (abstract).
12. Edge JA, Ford-Adams ME, Dunger DB. Causes of death in children with insulin dependent diabetes 1990-96. Arch Dis Child 1999; 81:318-23.
13. Edge JA, et al. The risk and outcome of cerebral oedema developing during diabetic ketoacidosis. Arch Dis Child 2001; 85:16-22.
14. Glaser N, et al. Risk factors for cerebral edema in children with diabetic ketoacidosis. The Pediatric Emergency Medicine Collaborative Research Committee of the American Academy of Pediatrics. N Engl J Med 2001; 344:264-9.
15. Kanter RK, et al. Arterial thrombosis causing cerebral edema in association with diabetic ketoacidosis. Crit Care Med 1987; 15:175-6.
16. Moll GW Jr, et al. Rhinocerebral mucormycosis in IDDM. Sequential magnetic resonance imaging of long-term survival with intensive therapy. Diabetes Care 1994; 17:1348-53.
17. Young MC. Simultaneous acute cerebral and pulmonary edema complicating diabetic ketoacidosis. Diabetes Care 1995; 18:1288-90.
18. Breidbart S, et al. Adult respiratory distress syndrome in an adolescent with diabetic ketoacidosis. J Pediatr 1987; 111:736-8.
19. Watson JP, Barnett AH. Pneumomediastinum in diabetic ketoacidosis. Diabet Med 1989; 6:173-4.
20. Cateels K, et al. Rhabdomyolysis in diabetic ketoacidosis. Pediatric Diabetes 2003; 4:29-31.
21. Rewers A, et al. Predictors of acute complications in children with type 1 diabetes. JAMA 2002; 287:2511-18.
22. Kaufman FR, Halvorson M: The treatment and prevention of diabetic ketoacidosis in children and adolescents with type 1 diabetes mellitus. Pediatr Ann 1999; 28:576-82.
23. Grey M, et al. Coping skills training for youth with diabetes mellitus has longlasting effects on metabolic control and quality of life. J Pediatr 2000; 137:107-13.
24. Drozda DJ, et al. Assessment of the effect of a comprehensive diabetes management program on hospital admission rates of children with diabetes mellitus. Diabetes Educ 1990; 16:389-93.
25. Malone JI, Root AW. Plasma free insulin concentrations: keystone to effective management of diabetes mellitus in children. J Pediatr 1981; 99:862-7.
26. Chase HP, Garg SK, Jelley DH. Diabetic ketoacidosis in children and the role of outpatient management. Pediatr Rev 1990; 11:297-304.
27. Alavi IA, Sharma BK, Pillay VK. Steroid-induced diabetic ketoacidosis. Am J Med Sci 1971; 262:15-23.
28. Cetin M, Yetgin S, Kara A, Tuncer AM, Gunay M, Gumruk F, Gurgey A.Hyperglycemia, ketoacidosis and other complications of L-asparaginase in children with acute lymphoblastic leukemia. J Med 1994; 25(3-4):219-29.
29. Dawson KP, Penna AC, Manglick P. Acute asthma, salbutamol and hyperglycaemia. Acta Paediatr. 1995 Mar; 84(3):305-7.
30. Musumba CO, Pamba AO, Sasi PA, English M, Maitland K. Salicylate poisoning in children: report of three cases. East Afr Med J 2004; 81(3):159-63.
31. Ferner RE. Drug-induced diabetes. Baillieres Clin Endocrinol Metab 1992 Oct;6(4):849-66.
32. Smith CP, et al. Ketoacidosis occurring in newly diagnosed and established diabetic children. Acta Paediatr 1998; 87:537-41.
33. Morris AD, et al. Adherence to insulin treatment, glycaemic control, and ketoacidosis in insulin-dependent diabetes mellitus. The DARTS/MEMO Collaboration. Diabetes Audit and Research in Tayside Scotland. Medicines Monitoring Unit. Lancet 1997; 350:1505-10.
34. Golden MP, Herrold AJ, Orr DP. An approach to prevention of recurrent diabetic ketoacidosis in the pediatric population. J Pediatr 1985; 107:195-200.
35. Flood RG, Chiang VW. Rate and prediction of infection in children with diabetic ketoacidosis. Am J Emerg Med 2001; 19:270-3.
36. Glasgow AM, et al. Readmissions of children with diabetes mellitus to a children's hospital. Pediatrics 1991; 88:98-104.
37. Monroe KW, King W, Atchison JA. Use of PRISM scores in triage of pediatric patients with diabetic ketoacidosis. Am J Manag Care 1997; 3:253-8.
38. Edge JA. Cerebral oedema during treatment of diabetic ketoacidosis: are we any nearer finding a cause? Diabetes Metab Res Rev 2000; 16:316-24.
39. Deeb L. Development of fatal cerebral oedema during outpatient therapy for diabetic ketoacidosis. Pract Diab 1989; 6:212-13.
40. Glasgow AM. Devastating cerebral edema in diabetic ketoacidosis before therapy. Diabetes Care 1991; 14:77-8.
41. Rosenbloom AL. Intracerebral crises during treatment of diabetic ketoacidosis. Diabetes Care 1990; 13:22-33.
42. Muir A. Therapeutic controversy. Cerebral edema in diabetic ketoacidosis: a look beyond rehydration. J Clin Endocrinol Metab 2000; 85:509- 13.
43. Finberg L: Why do patients with diabetic ketoacidosis have cerebral swelling, and why does treatment sometimes make it worse? Arch Pediatr Adolesc Med 1996; 150:785-786.
44. Bello FA, Sotos JF. Cerebral oedema in diabetic ketoacidosis in children. Lancet 1990; 336:64.
45. Mahoney CP, Vlcek BW, DelAguila M. Risk factors for developing brain herniation during diabetic ketoacidosis. Pediatr Neurol 1999; 21:721-7.
46. Marcin JP, Glaser N, Barnett P, McCaslin I, Nelson D, Trainor J, Louie J, Kaufman FR, Quayle K, Roback M, Malley R, Kuppermann N: Factors associated with adverse outcomes in children with diabetic ketoacidosis-related cerebral edema. J Pediatr 2002; 141:793-97.
47. Krane EJ, et al. Subclinical brain swelling in children during treatment of diabetic ketoacidosis. N Engl J Med 1985; 312:1147-51.
48. Hoffman WH, et al. Cranial CT in children and adolescents with diabetic ketoacidosis. AJNR Am J Neuroradiol 1988; 9:733-9.
49. Hoffman WH, et al. Computer analysis of magnetic resonance imaging of the brain in children and adolescents after treatment of diabetic ketoacidosis. J Diabetes Complications 1999; 13:176-81.
50. Franklin B, Liu J, Ginsberg-Fellner F. Cerebral edema and ophthalmoplegia reversed by mannitol in a new case of insulin-dependent diabetes mellitus. Pediatrics 1982; 69:87-90.
51. Shabbir N, et al. Recovery from symptomatic brain swelling in diabetic ketoacidosis. Clin Pediatr (Phila) 1992; 31:570-3.
52. Roberts MD, Slover R, Chase HP. Diabetic ketoacidosis with intracerebral complications. Pediatr Diabetes 2001; 2:109-14.
53. Tubiana-Rufi N, Thizon-de Gaulle I, Czernichow P. Hypothalamopituitary deficiency and precocious puberty following hyperhydration in diabetic ketoacidosis. Horm Res 1992; 37:60-3.
54. Lufkin EG, et al. Acute cerebral dysfunction in diabetic ketoacidosis: survival followed by panhypopituitarism. Metabolism 1977; 26:363-9.
55. Keller RJ, Wolfsdorf JI. Isolated growth hormone deficiency after cerebral edema complicating diabetic ketoacidosis. N Engl J Med 1987; 316:857-9.
56. Dunlop KA, Woodman D, Carson DJ. Hypopituitarism following cerebral oedema with diabetic ketoacidosis. Arch Dis Child 2002; 87:337-8.