Slide no 2
                                                                                  Slide No 2
                                  Programme
   1     Managing DKA
   2     Treating and preventing hypoglycaemia
   3     Surgery in children with diabetes
                                                                                 Slide no 3
                                                                                 Slide No 3
      Diabetic Ketoacidosis
     • Occurs when there is insufficient insulin action
     • Commonly seen at diagnosis
     • Is a life-threatening event
     • Child should be transferred as soon as possible to the 
        best available site of care with diabetes experience 
        Initiate care at diagnosis 
                                                                                 Slide No 4
     Type 1 Diabetes
                                                     • Increased urine 
                                                     • Dehydration
                                                     • Thirst
                                                                                 Slide No 5
     DKA
               Liver                                  • Weight loss
                                                      • Ketones
    Muscle                                                 • Nausea
                                                           • Vomiting
                                                           • Abdominal pain
    Fat
                                                           • Altered level of 
                                                              consciousness
                                                      • Shock
                                                      • Dehydration
     Weight loss           Ketones
                                                                                   Slide no 6
                                                                                  Slide No 6
     Clinical features
          Pathophysiology                        Clinical features 
             (What’s wrong)                       (What do you see)
        • Elevated blood             • High lab blood glucose, glucose meter 
          glucose                      reading or urine glucose, polyuria, 
                                       polydypsia
        • Dehydration                • Sunken eyes, dry mouth, decreased 
                                       skin turgor, decreased 
                                       perfusion (shock rare)
        • Altered electrolytes       • Irritability, change in level of 
                                       consciousness 
        • Metabolic acidosis         • Acidotic breathing, nausea, vomiting, 
          (ketosis)                    abdominal pain, altered level of 
                                       consciousness