Diabetic ketoacidosis in an 11-year-old girl with type 1 diabetes mellitus: A case study

Abstract

Background: Diabetic ketoacidosis (DKA) is a life-threatening acute complication of type 1 diabetes mellitus (T1DM) in children that requires prompt recognition and management.

Purpose: To describe the clinical presentation, management, clinical course, and outcome of severe DKA in an 11-year-old girl with T1DM.

Method: A descriptive case study was conducted based on a retrospective review of the patient's medical records. Data included medical history, physical examination, laboratory findings, treatment, clinical progression, and outcome during hospitalization.

Results: An 11-year-old girl with a two-year history of T1DM and three previous episodes of DKA presented with weakness, shortness of breath, nausea, vomiting, abdominal pain, altered consciousness, Kussmaul breathing, and dehydration. Blood glucose was 336 mg/dL with ketonuria +3 at the community health center. Upon hospital admission, blood glucose was GDS 510 mg/dL, ketonuria was +4, and arterial blood gas analysis showed severe metabolic acidosis (pH 6.67; HCO₃⁻ 2.0 mmol/L). The patient received intravenous fluid therapy, continuous insulin infusion, and intensive monitoring. Consciousness improved on the second day, and metabolic acidosis resolved on the third day (pH 7.40; HCO₃⁻ 22.2 mmol/L). The patient was discharged in stable condition after six days.

Conclusion: Early recognition, prompt referral, intensive monitoring, and appropriate management resulted in favorable clinical recovery.