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November 28, 2001

Hyperglycemia and DKA

Question from Jerusalem, Israel:

You recently answered a question about severe cerebral edema after DKA [diabetic ketoacidosis] and mentioned that in nearly all cases of severe DKA, there is some edema. Our three and a half year old daughter was diagnosed at age 12 months with sudden, severe onset of DKA and was non-responsive for about 48 hours. We were not told that she was in a coma, but she did not follow things with her eyes, and we're not sure she recognized us. I do know that during our hospital stay, a neurologist looked into her eyes with some equipment. She seems to have been developing normally, is bright, and is in decent control with the help of an insulin pump. Should we be concerned about any long lasting effects of her initial DKA almost three years ago?

Answer:

“All’s well that ends well”, and I don’t think that you need be concerned about any significant lasting cerebral impairment. The neurologist was probably using an ophthalmoscope to look at the back of her eyes for evidence of edema. Of course you all deserve a medal for having a three year old doing so well on an insulin pump, not a record, but certainly in the’magna cum laude’ bracket.

DOB