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Complications Of Untreated Dka

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Rare Complications Of Pediatric Diabetic Ketoacidosis

Go to: CEREBRAL EDEMA Many children who present with DKA have some degree of altered mental status. Typically the altered status is due to acidosis or hyperosmolarity, although some studies show that subclinical cerebral edema occurs in the majority of patients in DKA[9,10]. Approximately 0.5%-1% of children in DKA develop frank cerebral edema[11-13]. Morbidity related to cerebral edema is approximately 13%-35% and mortality 24%-28%[12,14]. Risk factors for the development of cerebral edema during DKA include new onset T1DM, low bicarbonate, low partial pressure of CO2, and high BUN[13,15]. Conventional thinking attributes the mechanism of injury in cerebral edema to swelling from an influx of fluid into the brain[15-17]. This influx is thought to be due to the rapidly declining serum osmolarity caused by overly aggressive fluid resuscitation; however, data reveals the only treatment-related risk factor to be administration of bicarbonate[15]. The association between high fluid infusion rates and development of cerebral edema trends toward, but does not reach, statistical significance[13]. Radiographic confirmation of cerebral edema in patients with DKA prior to initiation of fluid Continue reading >>

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Popular Questions

  1. dalejr8fan

    Ever since starting Atkins (Saturday - 3/13), my hands and feet are always cold. No matter what I do, I can't seem to get them warm. I wear two or three pairs of socks and they're still like ice. I've even put my gloves on in the house hoping to warm them up. I do live in a cold area (Michigan), but I've lived here my entire life, so cold weather isn't something new (plus, it's not been THAT cold really). In an effort to get my hands and feet warm, I'm roasting the rest of my family out of our home.
    Has anyone else experienced this? Is it normal? Or something I should possibly call my doctor about?
    Thanks!
    Brandee ~

  2. NOGAINHERE

    ya klnow I've had cold hands and feet a lot lately too. :?

  3. cmcole

    I heard lots of people say they were cold.
    It happens occasionally to me.
    I keep wondering if I'm eating enough fat or protein that day.
    Today is bad.
    My breakfast was spoiled on the way to work (I carry it in a container and nuke it once I've arrived). It spilled all over my backpack.
    Anyway, I ended up mixing up a shake (happened to have a package that my hubby had purchased for me - just coincidental).
    So, I haven't eaten anything substantial today, and I'm finding I'm cold. My fingers and toes are really like ice today. I still think my original theory is valid - I haven't eaten anything to burn off, creating heat.
    Other times, I'm fine. Other "cold" triggers are hunger or tiredness, for me. I notice it both times. So, perhaps it's more my body talking to me, than the real temperature outside my clothes.

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