Type 1 Diabetes and Children

Diabetes Information and Resources

PLEASE NOTE:  If your child is showing any of these symptoms before being diagnosed with diabetes, please contact a physician to have them tested immediately.

What is Diabetic Ketoacidosis (DKA)

 

Diabetic Ketoacidosis (DKA), is caused when the body does not have enough insulin. If the body does not have enough insulin, fat is broken down and used for energy for the body cells. Ketones are produced if fat is broken down. Ketones are acids. The body tries to maintain a normal pH by releasing basis to counteract  the extra acids in the blood stream.  If to many ketones are formed quickly, the body cannot maintain a normal blood pH.  If the blood pH is too low, the condition is called acidosis.  If the acidosis is caused by the ketone build up from not enough insulin, the condition is called diabetic ketoacidosis.  

Signs and Symptoms of DKA

 

Some symptoms and signs to look for in DKA:

  • Signs and symptoms of hyperglycemia (high blood sugar)
  • Dehydration
  • Weakness and extreme tiredness
  • Nausea
  • Vomiting
  • Abdominal pain
  • Confusion
  • Deep and rapid breathing with fruity odor to breath
  • Not urinating
  • Dry lips and mouth
  • Circles under the eyes

Causes of DKA

 

DKA is caused by the following:

  • Newly diagnosed diabetes
  • Not taking insulin or insulin that has gone bad
  • Interupption of insulin delivery from insulin pump
  • Infection, illness, or trauma

 

Treatment of DKA

 

DKA is life threatening. 

The child must be treated immediately to prevent death.  The child will be hospitalized and receive IV fluids, IV insulin, have lab checks and electrolyte replacement.  If infection is the cause for DKA, it will also be treated.

Complications from DKA may include cerebral edema (swelling of the brain), and pulmonary edema (fluid in the lungs). After diagnosis and treatment of diabetes, DKA is mainly preventable.

Repeated episodes of DKA in teenagers may be a clue to underlying psychological issues and noncompliance.  Children and teens performing diabetes self care skills such as insulin injections and blood sugar checking should always be supervised by a trained responsible adult.  Children and teenagers do not posses the maturity level to consistentlycare for their own diabetes without help from their family.

Prevention of DKA

 

Steps you can take to prevent DKA:

  • Take insulin as prescribed
  • Make sure insulin bottles are dicarded 1 month after opening
  • If you suspect that a bottle of insulin is bad, discard it and open a new bottle
  • Check blood sugar levels 4 or more times a day.
  • Check ketones if blood sugar levels are over 300 mg/dl
  • Discard vials of ketone check strips 6 months after opening the vial or when the expiration date has occurred (whichever comes first)
  • Check ketones if ill, having surgery, or under increased stress
  • Follow sick day guidelines
  • If using an insulin pump, check blood sugar levels one hour after inserting new infusion set.