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A 2004 statement by the European Society for Paediatric Endocrinology and the Lawson Wilkins Pediatric Endocrine Society (for children) uses slightly different cutoffs, where mild DKA is defined by pH 7.20–7.30 (bicarbonate 10–15 mmol/L), moderate DKA by pH 7.1–7.2 (bicarbonate 5–10) and severe DKA by pH<7.1 (bicarbonate below 5).
Russell-Silver syndrome can cause pathologic ketotic hypoglycemia. Any genetic or metabolic defect that interferes with the body's ability to maintain glucose homeostasis can trigger pathologic ketotic hypoglycemia, in which episodes of ketotic hypoglycemia persist in children despite increasing age. [2]
DKA is a serious complication which is particularly common in children under five years of age and can lead to cerebral edema, coma, and death. [ 9 ] A 2013 publication also stated that children who develop T1D while enrolled in TEDDY are diagnosed sooner after the onset of the disease than those not in the study.
The management of KPD revolves around 3 main components: acutely managing DKA, identification of KPD subtype, and longterm diabetic management similar to that in type 2 diabetes. [6] As patients are likely to initially present in DKA, the acute management of DKA is the first priority.
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Diabetic ketoacidosis (DKA) is one of the life-threatening severe complications of diabetes that demands immediate attention and intervention. [7] It is considered a medical emergency and can affect both patients with T1D (type 1 diabetes) and T2D (type 2 diabetes), but it is more common in T1D. [8]
The major differential diagnosis is diabetic ketoacidosis (DKA). In contrast to DKA, serum glucose levels in HHS are extremely high, usually greater than 40-50 mmol/L (600 mg/dL). [6] Metabolic acidosis is absent or mild. [6] A temporary state of confusion (delirium) is also more common in HHS than DKA. HHS also tends to affect older people more.
The most pressing complication of type 1 diabetes are the always present risks of poor blood sugar control: severe hypoglycemia and diabetic ketoacidosis. Hypoglycemia – typically blood sugar below 70 mg/dL (3.9 mmol/L) – triggers the release of epinephrine, and can cause people to feel shaky, anxious, or irritable. [89]