DIABETIC KETOACIDOSIS IN THE PEDIATRIC INTENSIVE CARE UNIT : CLINICAL, EPIDEMIOLOGICAL AND EVOLUTIONARY PROFILE

Diabeticketoacidosis (DKA), a seriousmetabolic complication of diabeteslinked to insulindeficiency,isstillcommoninAfrica,particularlyinchildren,andrepresentsamajormedicalemergency. It represents a real public healthproblem in ourcontext. Our study highlights the epidemiological and clinical profile of childrenadmitted to intensive care for DKA, underlining the importance of early recognition of warning signs, rapid and protocolized management, and close monitoring of potential complications. A retrospectivestudywascarried out over a 12- monthperiod in the pediatric intensive care unit at the Abderrahim Harouchimotherchild Hospital, Chu ibn Rochd, Casablanca, and included 43 cases of DKA. The meanage of the patients was 6.7 years, with a femalepredominance. DKAwas inaugural in 58% of cases, and 39% of episodesweretriggered by infections, mainlyurinary and pulmonary. Clinically, 83% of childrenpresentedwithneurologicaldisorders,and68%withKussmauldyspnea.Severeacidosis (pH< 7.1)wasobservedin41% of cases,whileelectrolyteabnormalitiesincludedhyponatremia and hypokalemia. Treatmentwasbased on rehydration, insulintherapy, correction of fluid andelectrolyteimbalancesandtreatmentofthecause.Progressionwasfavorablein93%of patients,butthreedeathswererecorded,underliningtherisksassociatedwithdelayeddiagnosisandcomplications.Thisstudyhighlightstheimportanceofraisingawarenessofearlydiagnosis and prevention of precipitatingfactors, notably infections and therapeutic non- compliance, in order to improve management and reduceDKA-relatedmortality.