CONSENSUS STATEMENT ON DIABETIC KETOACIDOSIS IN CHILDREN AND ADOLESCENTS

Key words: Diabetic ketoacidosis, Type 1 Diabetes Mellitus, Consensus, Cerebral oedema

Background. Diabetic Ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with Type 1 Diabetes Mellitus (TIDM). Mortality is predominantly related to the occurrence of cerebral oedema; only a minority of deaths in DKA are attributed to other causes. Cerebral oedema occurs in about 0.3-1% of all episodes of DKA, and its aetiology, pathophysiology, and ideal method of treatment are poorly understood. There is debate as to whether physicians treating DKA can prevent or predict the occurrence of cerebral oedema, and the appropriate site for children with DKA to be managed. There is agreement that prevention of DKA and reduction of its incidence should be a goal in managing children with diabetes. Aims and Methods. To explore these issues, the European Society for Paediatric Endocrinology (ESPE) and the Lawson Wilkins Pediatric Endocrine Society (LWPES) convened a panel of expert physicians for a Consensus Conference. The Consensus Statement was developed with close partnership between ESPE, LWPES and the International Society for Pediatric and Adolescent Diabetes (ISPAD), all three organisations being represented by members who participated in the writing process. Each of the major topics had a presenter and recorder, responsible for review of the literature and for providing evidence based recommendations according to criteria used by the American Diabetes Association (ADA). Conclusion. This document summarises the final consensus reached and represents the current “state of the art”.