Diabetic Ketoacidosis (DKA) and Cerebral Oedema 2. er: Diabetic

Added on - 22 Sep 2019

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Running Header:DIABETIC KETOACIDOSIS (DKA) AND CEREBRAL OEDEMA1Diabetic Ketoacidosis (DKA) and Cerebral Oedema
Diabetic Ketoacidosis (DKA) and Cerebral Oedema2Contents1. Introduction............................................................................................................................32. Epidemiology of DKA and cerebral oedema due to DKA....................................................33. Recent research findings........................................................................................................44. Interventions...........................................................................................................................55. Conclusion..............................................................................................................................9
Diabetic Ketoacidosis (DKA) and Cerebral Oedema31.IntroductionDiabetic ketoacidosis as perSavageet al (2011), results when cells in the body are deprivedof glucose due to low secretion of insulin. This sugar or glucose unable to get into the bodycells remains into the blood. Although kidneys filter some of this glucose but maximumremains present in the blood and on the other hand as the body cells are deprived of theenergy, they break down stored fats and muscles to get the required energy. This gives rise toketone bodies due to the chemical imbalance that is incurred due to abnormality of insulinand this gives rise to a condition called DKA.Cerebral oedema is refereed to excessive accumulation of fluid in both intercellular andextracellular spaces of the brain. Is one of the major complications in DKA in children thateven lead to death.2. Epidemiology of DKA and cerebral oedema due to DKADKA in children in US and UK are one of the most common conditions of severe mortalityand morbidity. Cerebral oedema is one of the critical complication of DKA that arecommonly observed in children and in adolescents. DKA can result in the children with bothtype 1 and type 2 diabetes (Glaser et al, 2013). A health care professional trained in childrendiabetes management must go through the guidelines provided in Canadian DiabetesAssociation 2003 for preventing and managing children diabetes in a proper manner. It hasbeen reported that cerebral oedema is present in 1% of all the children with DKA. Almost 50-60% of children deaths with DKA occur due to cerebral oedema. It is established that DKArisk increases from 1% to 10% per patient each year and the risk is higher in adolescent andperipubertal girls who have poor metabolic control or have DKA, difficult familycircumstances and psychiatric disorders (Becker, 2017). Type 1 diabetes or T1D Exchange
Diabetic Ketoacidosis (DKA) and Cerebral Oedema4researchers from the largest multinational analysis of diabetic ketoacidosis found out in 2015that there are some common risk factors of DKA across five countries and although thecondition is preventable but it remains a serious threat to the patients with type 1 diabetes.Researchers has estimated that annual costs of treating DKA accounts for $90 millionannually as more than 12,700 paediatric patients gets diagnosed with DKA each year in theUS.It is clinically significant as per a recent research conducted in 2017, that more or less 1% ofDKA episodes in paediatric patients bears a mortality rate of 20-90% (Watts and Edge,2014). The overall mortality rates in suffering children and adolescents remains between 0.15to 0.51% as per the national population study in the United States and Canada, UK.3. Recent research findingsAs per a recent research conducted byDeCourceyet al (2013), it was seen in a populationbased study in UK that presence of cerebral oedema is three times more common to thechildren with new onset diabetes rather than those who have been detected with diabetesearlier. A multicentre study was conducted with 61 children suffering from cerebral oedemaand it was seen treatment with bicarbonate are common with these cases. The researchersalso found out that patients who have low serum sodium concentration with low bloodglucose level are also prone to this disease.Patient with diabetes are more prone to develop DKA in future. The initial symptoms arepolyuria and polydipsia which often goes unnoticed by the parents (Cameron et al., 2014).When diabetes progresses, it may precipitates other complications that can be fatal to thesuffering child’s life if it is not treated in time. The symptoms of DKA includes
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