Monitoring of DKA-related Cerebral Oedema: Challenges and Perspectives
Added on 2019-09-22
14 Pages3817 Words251 Views
|
|
|
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. Introduction Diabetic ketoacidosis as per Savage et al (2011), results when cells in the body are deprived of glucose due to low secretion of insulin. This sugar or glucose unable to get into the body cells remains into the blood. Although kidneys filter some of this glucose but maximum remains present in the blood and on the other hand as the body cells are deprived of the energy, they break down stored fats and muscles to get the required energy. This gives rise to ketone bodies due to the chemical imbalance that is incurred due to abnormality of insulin and this gives rise to a condition called DKA.Cerebral oedema is refereed to excessive accumulation of fluid in both intercellular and extracellular spaces of the brain. Is one of the major complications in DKA in children that even 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 mortality and morbidity. Cerebral oedema is one of the critical complication of DKA that are commonly observed in children and in adolescents. DKA can result in the children with both type 1 and type 2 diabetes (Glaser et al, 2013). A health care professional trained in children diabetes management must go through the guidelines provided in Canadian Diabetes Association 2003 for preventing and managing children diabetes in a proper manner. It has been 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 DKA risk increases from 1% to 10% per patient each year and the risk is higher in adolescent and peripubertal girls who have poor metabolic control or have DKA, difficult family circumstances 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 2015 that there are some common risk factors of DKA across five countries and although the condition 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 million annually as more than 12,700 paediatric patients gets diagnosed with DKA each year in the US.It is clinically significant as per a recent research conducted in 2017, that more or less 1% of DKA 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 by DeCourcey et al (2013), it was seen in a population based study in UK that presence of cerebral oedema is three times more common to the children with new onset diabetes rather than those who have been detected with diabetes earlier. A multicentre study was conducted with 61 children suffering from cerebral oedema and it was seen treatment with bicarbonate are common with these cases. The researchers also found out that patients who have low serum sodium concentration with low blood glucose level are also prone to this disease.Patient with diabetes are more prone to develop DKA in future. The initial symptoms are polyuria 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 the suffering child’s life if it is not treated in time. The symptoms of DKA includes
End of preview
Want to access all the pages? Upload your documents or become a member.
Related Documents