Ali Afzal, Hassan Zaheer, Wasim Ahmed Jamalvi, Kashif Nisar, Iqbal Mazahir.
Presentation and precipitating factors of Diabetic Ketoacidosis in children.
Ann Abbasi Shaheed Hosp Karachi Med Dent Coll Jan ;10(2):766-74.

Objectives: To identify the frequency of various presentations, precipitating factors of Diabetic Ketoacidosis (DKA) in children, and to correlate the incidence of DKA with age and socioeconomic conditions. Study Design: A cross-sectional study Settings & duration: JMDCH, January 2004 – October 2004. Material & Methods: The convenient sample of 50 histories was collected from pediatric departments of various public and private sector hospitals of Karachi. Results: A total of 50 cases were analyzed out of which most of the cases were undiagnosed (64%) and belonged to low socioeconomic group (58%). Mean age of male patients was significantly lower as compared to females (5.5 +/- 2.31 vs 7.54 +/- 3.05, P<0.05), while status of hydrogen ion concentration (pH) was significantly lower in females (7.16 +/- 1.46 vs 7.26 +/- 0.08, p<0.05). Most frequent presenting complaints were vomiting, abdominal pain, dehydration and respiratory distress (34%). The most frequent precipitating factor was fever in 17 (34%) cases. Conclusion: More than half of the cases are undiagnosed and belong to low socioeconomic group. The level of awareness towards diagnosis of disease increases with the socioeconomic conditions, DKA affects both the genders equally; males being affected at an earlier age group. Most frequent presenting complaints are vomiting, abdominal pain, dehydration and respiratory distress while fever is the chief precipitating factor.

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