Higher BMI linked to increased death risk from ketoacidosis in diabetic children

Higher body mass index (BMI) and blood urea nitrogen (BUN) levels are linked to an increased chance of dying from diabetic ketoacidosis in children, according to an article in Endocrine Today.

The article on the research study from Advocate Lutheran General Children's Hospital in Illinois analyzed data on children admitted to the hospital with diabetic ketoacidosis during a six-year period.

The researchers collected data on the 10 children who died and the 122 children who survived the condition during that time. They compared data on serum glucose, creatinine, blood urea nitrogen, calculated osmolality and BMI.

BMI and BUN as predictors of mortality

The data showed that both BMI and BUN were significant predictors of mortality among children with diabetic ketoacidosis.

Children with diabetic ketoacidosis were more likely to die if BMI was .30 and BUN was .40 mg/dL.

“Despite our small sample size, our results suggest that children with higher BMI and BUN are at increased risk of death from [diabetic ketoacidosis]. Further study is needed to confirm and extend these findings,” wrote the authors of the study.

Ketoacidosis more common in type 1

Diabetic ketoacidosis most often occurs in people with type 1 diabetes, according to the National Institutes of Health (NIH). It is often the first sign that a person may have type 1 diabetes.

The condition occurs when the body does not have enough insulin to break down glucose in the blood for energy and uses fat for energy instead. Acids called ketones build up in the blood and urine as fats are broken down.

When ketones are present at high levels, they are poisonous. Then, blood glucose levels rise because the liver compensates by making glucose.

Common symptoms of diabetic ketoacidosis include rapid breathing, decreased consciousness, dry skin and mouth, flushed face, fruity smelling breath, nausea and vomiting, stomach pain.

The condition can lead to severe illness or death. It can cause fluid buildup in the brain, heart attack and death of bowel tissue due to low blood pressure, and kidney failure.

Though rare, people with type 2 diabetes can develop ketoacidosis. It typically is caused by a severe illness.

Sources: Endocrine Today, National Institutes of Health