Paediatric Hyperglycaemia

Question 1

Paediatric Hyperglycaemia CPG age range

Answer 1

<16 years of age

Question 2

When should DKA be suspected in a paediatric Hyperglycaemia

Answer 2

• Pre-exisitng history of diabetes
• BGL >11mmol/L
• Clinical features of DKA (Confusion, signs of dehydration, Kussmaul’s breathing)

Question 3

How many patients with a low-moderate hyperglycaemia will present with DKA

Answer 3

• Approximately a half

Question 4

When should HHS be suspected in a hyperglycaemic paediatric

Answer 4

• Typically older
• Have higher BGL readings >30mmol
• Usually do not present with clinical features of DKAS

Question 5

Should patients be encouraged to use additional insulin prior to Tx

Answer 5

• No

Question 6

What are 6 signs of hyperglycaemia

Answer 6

• Kussmaul’s breathing
• Confusion
• Polydipsia
• olyuria
• Tachypnoea
• Dehydration

Question 7

What can MICA do for paeditric Hyperglycaemic patients

Answer 7

• 10ml/kg Fluid IV

Question 8

What management can be done for a paediatric hyperglycaemic patient?

Answer 8

• Nausea and vomiting

Question 9

What are the 12 steps of DKA

Answer 9

1. Beta cells arent producing insulin
2. Cells aren’t being stimulated to uptake and use extracellular glucose
3. Pt enters a hyperglycaemic state
4. Insulin is no longer present to inhibit lipolysis
5. Lipids are being broken down into Fatty acids
6. Fatty acids uptaken by heaptocytes and transformed into ketones
7. Ketones build up and begin decreasing the pH
8. Increased glucose levels leads to Osmotic Diuresis
9. Leads to severe fluid depletion and electrolyte loss specifically potassium
10. Shock
11. Coma
12. Death

Question 10

Can DKA occur in Type 2 Diabetic patients?

Answer 10

Yes
Roughly 20% of DKA patients in the UK had Type 2 diabetes