Clinical laboratory contribution to the diagnosis and monitoring of pediatric diabetic ketoacidosis

Diabetic ketoacidosis (DKA) is a serious complication of childhood diabetes, which is all the more concerning when it reveals the disease. It constitutes a real public health issue, particularly because it can be prevented through early diagnosis. This study is retrospective, descriptive, and single-center, including 39 children hospitalized at the Cheikh Khalifa International University Hospital in Casablanca, Morocco, over a four-year period between 2018 and 2022. This study highlights a male predominance (56.4%) with a median age of 9 years. The most frequent clinical signs at admission were polyuropolydipsia syndrome (79.5%), weight loss (51%), polyphagia (30.8%), dyspnea (48%), digestive disorders (38%), vigilance disorders (25%) and secondary enuresis (10%). The mean blood glucose level at admission was 4.85 g/L ± 1.38, with glycosuria and ketonuria present in 77% of cases. Mild to moderate ketoacidosis was found in 35.9% of children. Biologically, hyperleukocytosis (79%), high CRP (21%), and high HbA1c were observed in 100% of cases (mean 11.3%, range 8.2-15.1%). DKA was mild to moderate in 35.9% of cases. The role of the laboratory is essential for diagnosis, monitoring, and identification of triggering factors, contributing to better management and prevention of recurrences.