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The purpose of this guideline is to improve the management of paediatric diabetic ketoacidosis (DKA). It is intended for healthcare professionals, particularly those in training, who are working in HSE-funded paediatric and neonatal services and is designed to guide clinical judgement but not replace it. In individual cases a healthcare professional may, after careful consideration, decide not to follow the guideline if it is deemed to be in the best interests of the child.
Severe DKA is the commonest cause of diabetes-related deaths in children and adolescents. Most deaths in DKA occur in young people as a result of cerebral oedema. Treatment is distinctly different from adults because of the risk of cerebral oedema. Prevention of DKA by earlier diagnosis at onset of diabetes, immediate referral and support for those challenged by diabetes self- care is the goal. Optimal management of established DKA is key to reducing morbidity and mortality.