Diabetic Keto-acidosis- Practice points

DIAGNOSIS OF DIABETIC KETOACIDOSIS- DKA

• 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.