Child, Diabete Type 1, Ketoacidosis, Diabetic, Pediatrics
Conditions
Keywords
Anemia, Ketoacidosis, Diabetic, Child, Hemoglobin, pediatric emergency
Brief summary
This retrospective observational cohort study aims to evaluate the association between hemoglobin levels and the time to resolution of diabetic ketoacidosis (DKA) in pediatric patients. The primary hypothesis is that children with anemia experience a longer duration of DKA and prolonged hospitalization compared with non-anemic children. All eligible patients aged 1-18 years who were diagnosed with DKA between 01.01.2013 and 01.01.2025 at a tertiary pediatric center will be included. Clinical, laboratory, and treatment data will be collected from electronic medical records.
Detailed description
This retrospective observational study investigates whether hemoglobin (Hb) levels, measured within 0-24 hours after biochemical resolution of diabetic ketoacidosis (DKA), are associated with the time to DKA resolution in pediatric patients. DKA resolution is defined as achievement of a venous pH ≥ 7.30 and a serum bicarbonate level ≥ 15 mmol/L. Only the first documented DKA episode for each patient will be included in the analysis. Secondary outcomes include pediatric intensive care unit (PICU) length of stay, total hospital length of stay, and DKA-related complications such as hypoglycemia, electrolyte disturbances, and suspected cerebral edema. Exploratory analyses will assess the association of pre-DKA hemoglobin levels (when available), hemoglobin levels at hospital discharge, and dehydration severity-reflected by admission hematocrit-with clinical outcomes.
Interventions
None listed
Sponsors
Aydin Adnan Menderes University
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
1 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* Age between 1 and 18 years * Diagnosis of diabetic ketoacidosis (DKA) according to ISPAD criteria * First documented episode of DKA * Availability of hemoglobin measurement obtained within 0-24 hours after biochemical resolution of DKA * Availability of documented timestamps for initiation of DKA treatment and biochemical resolution
Exclusion criteria
* Hyperosmolar hyperglycemic state (HHS) or mixed DKA-HHS presentation * Known hemoglobinopathies (e.g., thalassemia major, sickle cell disease) * Evidence of active hemolysis documented in medical records (e.g., elevated lactate dehydrogenase, indirect hyperbilirubinemia, or low haptoglobin) * Red blood cell transfusion administered before or during the DKA treatment period * Missing hemoglobin measurement within the predefined post-resolution window (0-24 hours)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to Resolution of Diabetic Ketoacidosis | From initiation of DKA treatment until biochemical resolution, assessed up to 7 days | Time from initiation of DKA treatment to biochemical resolution of DKA. Biochemical resolution is defined as achievement of a venous pH ≥ 7.30 and a serum bicarbonate level ≥ 15 mmol/L. The outcome is measured in hours and analyzed in relation to hemoglobin levels measured within 0-24 hours after DKA resolution. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pediatric Intensive Care Unit (PICU) Length of Stay | From PICU admission until PICU discharge, assessed up to 30 days | Length of stay in the pediatric intensive care unit measured from PICU admission to PICU discharge. The association with post-resolution hemoglobin levels will be evaluated. |
| Total Hospital Length of Stay | From hospital admission until hospital discharge, assessed up to 30 days | Total length of hospital stay measured from hospital admission to hospital discharge. The association between hospital length of stay and post-resolution hemoglobin levels will be evaluated. |
Countries
Turkey (Türkiye)
Outcome results
None listed