January - March 2020, Volume 16, Issue 1

Unal E, Pirinccioglu AG, Yanmaz SY, Yilmaz K, Taskesen M, Haspolat YK

A Different Perspective of Elevated Lactate in Pediatric Patients with Diabetic Ketoacidosis

Acta Endo (Buc) 2020, 16 (1): 114-117
doi: 10.4183/aeb.2020.114

Objective. This study aims to determine the frequency and prognostic significance of lactic acidosis in children with diabetic ketoacidosis (DKA) admitted to the pediatric intensive care unit. Methods. The study was carried out retrospectively by examining the patients admitted to the pediatric intensive care unit for the treatment of DKA. The ages of the patients ranged from 2 to 18 years. The patients with the following parameters were enrolled in the study: serum blood glucose>200 mg/dL, ketonuria presence, venous blood gas pH ≤7.1, bicarbonate <15. Results. A total of 56 patients were included in the study with a mean age of 111.07 ± 51.13 months. The recovery time from DKA was 16.05 ± 6.25 h in the group with low lactate level and it was 13.57 ± 8.34 h in the group with high lactate level with no statistically significant difference. There was a negative correlation between lactate levels and the recovery time from DKA. Conclusion. Lactic acidosis is common in DKA, and unlike other conditions, such as sepsis, it is not always a finding of poor prognosis that predicts the severity of the disease or mortality. We think that high lactate may even protect against possible brain edema-cerebral damage in DKA.

Keywords: Brain edema, children, diabetic ketoacidosis, intensive care, lactate.

Correspondence: Edip Unal MD, Dicle University, Faculty of Medicine, Department of Pediatric Endocrinology, Sur, Diyarbakir, Turkey, Tel.: +90 412 2488001, E-mail: edip76@yahoo.com