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Introduction

  • In pediatric patients, have a low threshold to check blood sugar
  • Undiagnosed diabetics commonly identified in ED during first episode of DKA
  • HYPOglycemia is very common in multiple conditions, especially in ill children

Hyperglycemia

  • DKA is different in kids
    • They get cerebral edema
      • Increased intracranial pressure with rapid fluid administration
    • Common symptoms
      • Headache
      • Altered mental status
      • Neurologic deficits
      • Cushings triad
        • Hypertension
        • Bradycardia
        • Irregular breathing
    • Treatment = mannitol

Hypoglycemia

  • Multiple causes
    • Sepsis
    • Inborn errors of metabolism
    • Endocrine disorders
  • Replace glucose using “Rule of 50s”
    • Dextrose % x Volume = 50
      • Neonates: 5ml/kg of D10
      • Pediatrics: 2ml/kg of D25
      • Teens/Adults: 1ml/kg of D50
    • 1 “amp” of D50 = 25g of sugar = 50ml

Additional Reading