Pediatric Diabetic Ketoacidosis Emergency Department Care Clinical Presentation

Updated: Jun 21, 2021
  • Author: Grace M Young, MD; Chief Editor: Sasigarn A Bowden, MD  more...
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Classic symptoms of diabetic ketoacidosis (DKA) are often absent in toddlers. If a patient has known diabetes, obtain a history for compliance with insulin regimens and the name of the patient's endocrinologist. Classic symptoms of DKA are as follows:

  • Often insidious

  • Fatigue and malaise

  • Nausea/vomiting

  • Abdominal pain

  • Polydipsia

  • Polyuria

  • Polyphagia

  • Weight loss

  • Fever


Physical Examination

Physical examination may reveal the following:

  • Altered mental status without evidence of head trauma

  • Tachycardia

  • Tachypnea or hyperventilation (Kussmaul respirations)

  • Normal or low blood pressure

  • Increased capillary refill time

  • Poor perfusion

  • Lethargy and weakness

  • Fever

  • Acetone odor of the breath reflecting metabolic acidosis