Diabetic Keto-acidosis- Practice points

  • Blood Glucose >200mg/dl
    • Blood pH <7.3
    • Bicarbonate <15 mmol/L
    • Ketones present in blood/urine
  • If you diagnose a child with DKA – refer to a higher center (preferably with PICU facilities) for further management.
Do’s & dont’s for diabetics in acute illnesses
  • DO NOT STOP INSULIN injections even if child is eating less.
  • Give plenty of  sugar free fluids every 24 hours to prevent dehydration.
  • Frequent checking of blood sugars (every 2-4 hours).
  • Check for ketones in urine, even if blood sugars are between 150-200 mg/dl range.
When to consult a doctor- instructionS for parents
  1. Fever> 100.5 for > 2 days
  2. The child is unable to eat or drink anything, even small sips of water 
  3. Persistent Vomiting & diarrhea
  4. Blood sugar > 200mg/dl despite insulin dosage adjustment
  5. Moderate to large ketones in urine
  6. Unsure of insulin dosage adjustment if ketones are present
  7. Child shows any symptoms of diabetic ketoacidosis :  fruity breath, dehydration, dry lips, difficulty in breathing, stomach cramps, etc.
  8. Child is drowsy.

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