Etiology of Diabetic Ketoacidosis (DKA) in Children

- Diabetic ketoacidosis (DKA) is a serious complication of diabetes mellitus in children, characterized by hyperglycemia, ketosis, and metabolic acidosis

- DKA occurs more frequently in children with type 1 diabetes mellitus (T1DM), but it can also occur in children with type 2 diabetes mellitus (T2DM) or gestational diabetes mellitus (GDM)

- The etiology of DKA in children involves a combination of factors, including insulin deficiency, increased counter-regulatory hormone levels, and dehydration

- Insulin deficiency, which can result from missed insulin doses, illness, or other factors, leads to uncontrolled glucose production by the liver and impaired glucose uptake by peripheral tissues, leading to hyperglycemia

- Increased counter-regulatory hormone levels, such as glucagon, cortisol, and growth hormone, further exacerbate hyperglycemia and stimulate lipolysis, leading to the production of ketone bodies

- Dehydration, which can result from osmotic diuresis and vomiting, further exacerbates the metabolic derangements in DKA by reducing renal perfusion and exacerbating acidosis