Author(s)

Aymar Pierre Gildas Oko^*, Judicael Kambourou, Engoba Moyen, Laetitia Lombet, Neli Yvette Ngakengni, Steve Vassili Missambou Mandilou, Aurore Mbika Cardorelle, Georges Marius Moyen

Faculty of Health Sciences, Marien Ngouabi University of Brazzaville, Brazzaville, Congo.

Background: Severe hypoglycemia is a lifethreatening iatrogenic complication in the management of diabetic ketoacidosis, however, few studies have described how often this complication occurs. Objective: To identify the risk factors for severe hypoglycemia in children treated for diabetic ketoacidosis and to describe the sociodemographic, clinical characteristics and outcome of these children. Methods: From January 2013 to December 2017, 69 children admitted to pediatric intensive care unit with a diagnosis of diabetic ketoacidosis were enrolled in a retrospective and prospective study. Data of children with and without severe hypoglycemia were compared. Data were analyzed using Epi Info 7.1.5.0. Results: Out of 69 children enrolled, 10 (14.5%) had severe hypoglycemia (girls: 60%, median age 144 months (interquartile range, 108 - 168 months)). Episodes of severe hypoglycemia occurred during the first 48 hours of hospitalization in 8 (80%) children and during the late night shift in 6 (60%) children. Causes of severe hypoglycemia were: excessive insulin dose (60%), inappropriate infusion solution (70%), failure to properly monitor blood glucose levels (40%). Severe hypoglycemia risk factors were: age < 5 years (p = 0.00004; OR = 42.0 [95% CI: 6.3 - 279]) and severe malnutrition (p = 0.002; OR = 10.9 [95% CI: 2.4 - 48.6]). Of 8 (11.6%) children died, 4 had severe hypoglycemia (p = 0.01; OR = 8.8 [95% CI, 1.7 - 44.8]). Conclusion: The importance and severity of severe hypoglycemia require preventive measures to control risk factors.

Severe Hypoglycemia, Diabetic Ketoacidosis, Risk Factors, Brazzaville

Oko, A. , Kambourou, J. , Moyen, E. , Lombet, L. , Ngakengni, N. , Mandilou, S. , Cardorelle, A. and Moyen, G. (2020) Severe Hypoglycemia in Hospitalized Children with Diabetic Ketoacidosis in Brazzaville. Open Journal of Pediatrics, 10, 236-245. doi: 10.4236/ojped.2020.101024.