Abstract

Diabetic ketoacidosis (DKA) is characterized by a triad of hyperglycemia, acidosis and ketonemia. Microalbuminuria is an early predictor of diabetic nephropathy and is associated with higher levels of HbA1c. The present study aimed to evaluate the role of Microalbuminuria and HbA1c in the assessment of diabetes control in children with T1DM hospitalized with diabetic ketoacidosis Material & Methods: After taking approval from IEC, this prospective study was conducted on 38 children <18 years of age who presented for the first time with T1DM or with established T1DM admitted to Pediatric ICU at IMCHRC, Indore. Patients qualifying inclusion criteria and exclusion criteria were enrolled after obtaining written informed consent. Detailed history including the duration of diabetes in established T1DM children along with clinical examination and investigations such as blood glucose, arterial blood gases, serum electrolytes, urine sugar, and urine ketone bodies was done. Statistical analysis was done by SPSS 22.0 version software with P value <0.05 statistically significant. Results: 21.1% had debut and 78.9% had established T1DM. On admission, 60% had poor HbA1c control and microalbuminuria was found in 18% with established T1DM (mean duration: 4.28 ± 1.25 years. A significant association was found between urine microalbuminuria and HbA1c > 9% and duration of diabetes > 4 years. A significant difference was found between the mean HbA1c value at the time of admission and three months after treatment (P <0.05). Conclusion: Assessment of microalbuminuria is needed in pediatric T1DM patients, especially in those with HbA1c > 9% and duration of diabetes > 4 years, to evaluate the risk of diabetic nephropathy.

Description