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25: Diabetes, Diabetic Ketoacidosis, and Type 2 Diabetes
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Published:May 2023
Kylie Durand, MD, FAAP, Asha Freeman, MD, FAAP, Roger Nicome, MD, FAAP, "Diabetes, Diabetic Ketoacidosis, and Type 2 Diabetes", Caring for the Hospitalized Child: A Handbook of Inpatient Pediatrics, American Academy of Pediatrics Section on Hospital Medicine, Jeffrey C. Gershel, MD, FAAP, Daniel A. Rauch, MD, FAAP, SFHM
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Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with type 1 diabetes mellitus (T1DM). DKA occurs when there is a disruption in the balance between insulin and the counterregulatory hormones from either a lack of circulating insulin or increased counterregulatory hormones in response to stress (trauma, acute gastroenteritis, sepsis). This imbalance leads to a catabolic state, which precipitates the hallmarks of DKA: hyperglycemia, hyperosmolality, increased lipolysis, ketonemia, and metabolic acidosis. An osmotic diuresis ensues, causing dehydration and the production of more counterregulatory hormones, further disrupting the balance.
Diabetic ketoacidosis can be the initial presentation of...
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