DIABETIC KETOACIDOSIS AND ACUTE PANCREATITIS IN CHILDREN’S CLINICAL UNIVERSITY HOSPITAL FROM 2015 TILL 2017

Introduction. Type 1 diabetes and pancreatitis both are common endocrine and exocrine pathologies of the pancreas in a pediatric population, while their acute presentations – diabetic ketoacidosis (DKA) and acute pancreatitis (AP) – require a prompt diagnosis and intensive treatment. Furthermore, as discussed in literature and research studies, there’s still space for more research on the interchanging relationships between DKA and AP. Aim. The aim of the study was to evaluate and analyze the characteristics and possible relations between DKA and AP in a pediatric population. Research tasks and methods. A retrospective evaluation of 207 pediatric cases, corresponding International Classification of Diseases (ICD-10) codes E10.1 and K85, for the time period of 2015–2017 was carried out. Statistical analysis was done using Microsoft Excel and IBM SPSS Statistics. Results. Most admission rates in the study group were due to type 1 diabetes with DKA (79,2%). DKA was a complication both in newly diagnosed (64%) and established type 1 diabetes patients (36%), and there was a significant correlation between the duration of illness and previous DKA episodes (p<0.01). The analysis of AP diagnostic criteria showed the presentation of abdominal pain in 97,7% AP patients and a correlation between lipase and abdominal imaging results (95,3% versus 75,6%; p<0,01). There was a nonspecific as well as marked increase, reaching diagnostic criteria, in pancreatic enzyme levels in type 1 diabetes patients with DKA and these findings were consistent with correlation between pH and lipase (p< 0.01). Conclusions. DKA is an important complication both in newly diagnosed and established type 1 diabetes patients, presenting at different times in the course of the disease, and in a number of patients a rise in pancreatic enzyme levels can occur that can be associated with metabolic acidosis. AP has established diagnostic standards, including physical, biochemical and visual diagnostical criteria, that were reaffirmed in this pediatric study group.