Clinical Profile and Outcome of Paediatric Patients with Diabetic Ketoacidosis: A Retrospective Cohort Study

Introduction: Diabetic Ketoacidosis (DKA) remains a life-threatening metabolic complication in children with Type 1 Diabetes Mellitus (T1DM), particularly in resource-limited settings. Early diagnosis and prompt management are vital for improving outcomes. Aim: To assess the clinical profile, laboratory parameters and outcomes of paediatric patients presenting with DKA and to identify factors associated with mortality. Materials and Methods: This retrospective cohort study included 40 paediatric patients diagnosed with DKA and admitted to the Paediatric Intensive Care Unit (PICU) of Malda Medical College and Hospital, Malda, West Bengal, India. Children under 12 years who were admitted with a diagnosis of DKA between January 1, 2022 and December 31, 2024, were included. Clinical history, physical examination findings, laboratory values and treatment outcomes were recorded. Data were analysed using Statistical Package for the Social Sciences (SPSS) software and associations between various parameters and outcomes were evaluated using appropriate statistical tests. Results: The highest proportion of DKA cases, 17 (42.5%), occurred in children aged 9 to 12 years. Both sexes were equally affected. Most patients, 21 (52.5%), belonged to a low Socioeconomic Status (SES). Common symptoms included vomiting in 29 (72.5%), polyuria in 27 (67.5%) and polydipsia in 23 (57.5%). Dehydration was observed in 34 (85%) and Kussmaul breathing in 26 (65%) of the patients. The mean arterial pH was 7.12±0.14 and the mean HbA1c was 5.61±0.70%. The mortality rate was 10% (n=4). Significant predictors of poor outcomes included low SES (p-value=0.004), a positive family history of diabetes (p-value=0.049), lower pH (p-value=0.0016), higher HbA1c (p-value=0.0035), elevated serum urea (p-value=0.0049) and creatinine (p-value=0.0021). Conclusion: Paediatric DKA continues to pose a serious clinical challenge. SES, family history and the degree of metabolic derangement significantly impact outcomes. Early recognition and timely management are critical in reducing mortality and improving prognosis.