Prevalence and Risk Factors Related to Cerebral Edema Associated With Diabetes Ketoacidosis in Pediatrics With Type-1 Diabetes Mellitus Publisher



Sarvari M ; Mohsenipour R ; Soti Khiabani M ; Mohammadi M S
Source: Journal of Pediatric Research Published:2026

Abstract

Aim: Cerebral edema associated with diabetes ketoacidosis (CEDKA) is the most important clinical challenge in children with type-1 diabetes mellitus (T1DM). CEDKA is associated with a high rate of morbidity and mortality. We investigated the prevalence and risk factors of CEDKA in children with T1DM. Materials and Methods: This observational study was conducted at the Children's Medical Center Hospital, Tehran, in children up to the age of 18 years with T1DM who presented with DKA from December 2022 to June 2024. All of the patients' demographic, clinical, and laboratory data were collected and analyzed. A p value <0.05 was considered significant. Results: In total, of the 427 patients included in this study, 204 (47.8%) were male, and their mean and standard deviation (SD) age was 8.11 (4.09) years. 100 patients (23.31%) had mild DKA, 149 (34.73%) had moderate DKA, and 178 (41.49%) had severe DKA. In this study, 8 patients (1.86%) had CE, 6 of these patients (75%) were male, and 2 of them (25%) were female, and their mean ± SD age was 9.12±2.64 years. In the analysis, factors such as pH levels [odds ratio (OR): 0.001, 95% confidence interval (CI): 0.00-0.44, p=0.00] and bicarbonate levels (OR: 0.55, 95% CI: 0.36-0.83, p=0.00) had an independent and significant relationship with the incidence of CE. Conclusion: The prevalence of CE was higher in severe DKA patients. Rapid diagnosis and management of DKA patients, especially those with neurological symptoms, is the most critical step in T1DM. Copyright 2026 The Author(s). Published by Galenos Publishing House on behalf of Ege University Faculty of Medicine, Department of Pediatrics and Ege Children's Foundation. Licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0)