Diabetic Ketoacidosis: A complication to Type 1 in Children
Diabetic Ketoacidosis (DKA) is a newly reported complication that could accompany type 1 diabetes diagnosis in children. DKA causes changes in the child’s brain matter that could lead to this loss of memory and attention that happens for at least 6 months following the diagnosis.
Every year around thirty thousand children and adults are diagnosed with type 1 diabetes as reported by the Juvenile Diabetes Research Foundation, a number that has increased largely with every passing year and 20 to 30% of those diagnosed with type 1 diabetes present diabetic ketoacidosis, but it is a complication that could present itself later if issues with diabetes management arise.
Type 1 diabetes is diagnosed when a patient’s immune system destroys the insulin producing cells by mistake, leaving the body with a very small amount or no insulin at all, needing a special hormone to convert food into fuel. If an amount of time passes without treatment the body could start burning fat for fuel leaving certain acids behind called ketones and a high level of these acids causes diabetic ketoacidosis.
According to Dr. Fergus Cameron, author of the study and chief of the diabetes services at the Royal Children’s Hospital in Victoria, Australia, “those diagnosed with type 1 diabetes and DKA have evidence of brain gray matter shrinkage and white matter swelling… While these changes resolve within the first week, there are associated cognitive changes (memory, attention) that are present for half year after the diagnosis.”
Dr. Cameron’s study was published online in the Diabetes Care journal on May 22nd. It included 95 children and teenagers between 6 and 18 years of age recently diagnosed with type 1 diabetes and 36 of those with diabetic ketoacidosis. During the study all 95 patients had an MRI done four times in a six month period, at 2 days after diagnosis, 5, 28 and at 6 months. On this study they also had tests of attention and memory. On the 36 diagnosed with type 1 diabetes and DKA they saw that all had divided attention scores and delayed memory recall, something very subtle but noticeable. As per Dr. Cameron, “Any decrement in attention or memory in children is a concern as children are acquiring new knowledge and learning new skills all the time.” He also pointed that previous researches hint that these changes may be longer lasting as his study only lasted six months.