Arora Amodini, Khan Owais Ali, Gupte Supriya, Patil Manojkumar G, Mane Shailaja
Pediatrics, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Pediatric Endocrinology, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Cureus. 2024 Sep 26;16(9):e70228. doi: 10.7759/cureus.70228. eCollection 2024 Sep.
Diabetic ketoacidosis (DKA) is a critical metabolic complication observed in newly diagnosed cases of type 1 diabetes. Severe hypertriglyceridemia, diagnosed in this case, is a rare consequence of DKA. A six-year-old female child presented to the casualty with drowsiness, reduced oral acceptance, difficulty in breathing, hyperglycemia for the past four hours, and polyuria for the past two and a half months. On examination, tachypnea and Kussmaul breathing were present, and the patient was drowsy and confused with a Glasgow coma scale score of 12/15. Grossly lipemic serum was obtained during routine sampling with deranged international normalized ratio (INR), severe hypertriglyceridemia, and refractory metabolic acidosis. According to the International Society for Pediatric and Adolescent Diabetes (ISPAD) guidelines 2023, maintenance fluids were administered intravenously as per blood sugar levels with potassium supplementation, including a deficit of 10%. Insulin was given intravenously at 0.1 IU/kg with a broad-spectrum antibiotic.
糖尿病酮症酸中毒（DKA）是1型糖尿病新诊断病例中观察到的一种严重代谢并发症。该病例中诊断出的严重高甘油三酯血症是DKA的罕见后果。一名6岁女童因嗜睡、经口进食减少、呼吸困难、过去4小时血糖升高以及过去两个半月多尿而被送往急诊室。检查发现呼吸急促和库斯莫尔呼吸，患者嗜睡且意识模糊，格拉斯哥昏迷量表评分为12/15。常规采血时获得严重脂血血清，国际标准化比值（INR）紊乱、严重高甘油三酯血症和难治性代谢性酸中毒。根据2023年国际儿童和青少年糖尿病协会（ISPAD）指南，根据血糖水平静脉输注维持液并补充钾，包括10%的亏空量。静脉注射胰岛素，剂量为0.1 IU/kg，并给予广谱抗生素。
