TITLE:
Severe Hypoglycemia in Hospitalized Children with Diabetic Ketoacidosis in Brazzaville
AUTHORS:
Aymar Pierre Gildas Oko, Judicael Kambourou, Engoba Moyen, Laetitia Lombet, Neli Yvette Ngakengni, Steve Vassili Missambou Mandilou, Aurore Mbika Cardorelle, Georges Marius Moyen
KEYWORDS:
Severe Hypoglycemia, Diabetic Ketoacidosis, Risk Factors, Brazzaville
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.10 No.1,
March
27,
2020
ABSTRACT: Background: Severe hypoglycemia is a lifethreatening iatrogenic complication in the management of diabetic ketoacidosis, however, few studies have described how often this complication occurs. Objective: To identify the risk factors for severe hypoglycemia in children treated for diabetic ketoacidosis and to describe the sociodemographic, clinical characteristics and outcome of these children. Methods: From January 2013 to December 2017, 69 children admitted to pediatric intensive care unit with a diagnosis of diabetic ketoacidosis were enrolled in a retrospective and prospective study. Data of children with and without severe hypoglycemia were compared. Data were analyzed using Epi Info 7.1.5.0. Results: Out of 69 children enrolled, 10 (14.5%) had severe hypoglycemia (girls: 60%, median age 144 months (interquartile range, 108-168 months)). Episodes of severe hypoglycemia occurred during the first 48 hours of hospitalization in 8 (80%) children and during the late night shift in 6 (60%) children. Causes of severe hypoglycemia were: excessive insulin dose (60%), inappropriate infusion solution (70%), failure to properly monitor blood glucose levels (40%). Severe hypoglycemia risk factors were: age p= 0.00004; OR = 42.0 [95% CI: 6.3-279]) and severe malnutrition (p= 0.002; OR=10.9 [95% CI: 2.4 -48.6]). Of 8 (11.6%) children died, 4 had severe hypoglycemia (p= 0.01; OR = 8.8 [95% CI, 1.7 -44.8]). Conclusion: The importance and severity of severe hypoglycemia require preventive measures to control risk factors.