Endocrine Abstracts

Cardiac complications including cardiac arrest in Diabetic Ketoacidosis (DKA) have been reported in adults but is not common in children. We present a case of a 3½ year old child with new onset Type 1 Diabetes who presented in severe DKA and went into cardiac arrest needing prolonged resuscitation after starting insulin infusion due to rapid drop of serum potassium (K+). Serum K+ on presentation was 2.8 mmol/l and dropped to 1.5 mmol/l within 2.5 h of starting insulin leading to cardiac arrest. Although the child survived but ended up with a week in PICU and significant neurological deficit. Failure to acknowledge and properly manage hypokalemia in DKA can result in severe, symptomatic hypokalemia with detrimental effects on the neuromuscular and cardiopulmonary systems and warrants consideration to closely follow K+ levels during management.¹

Reference: 1. Shanlee M Davis, et al. Profound hypokalemia associated with severe diabetic ketoacidosis, Pediatr Diabetes. 2016 Feb; 17(1): 61–65.