Open AccessNew‐onset type 1 diabetes complicated by diabetic ketoacidosis and severe sepsis requiring extracorporeal membrane oxygenation and kidney replacement therapy
Author(s) -
Nurul Aliah Mohd Asarani,
Justine Paddison,
Robert Walker,
Michelle Downie,
Benjamin J Wheeler
Publication year - 2021
Publication title -
journal of diabetes and metabolic disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.619
H-Index - 33
ISSN - 2251-6581
DOI - 10.1007/s40200-021-00736-z
Subject(s) - medicine , diabetic ketoacidosis , extracorporeal membrane oxygenation , renal replacement therapy , sepsis , diabetes mellitus , ketoacidosis , type 1 diabetes , intensive care medicine , inotrope , respiratory failure , cardiorespiratory fitness , pediatrics , surgery , cardiology , endocrinology
Diabetic ketoacidosis (DKA) accounts for up to a third of all new presentations of Type 1 Diabetes Mellitus (T1DM) in children and adolescents. While most cases are relatively uncomplicated new onset presentations, if DKA is compounded with an additional underlying severe illness, such as appendicitis or severe infection, diagnostic delays may be experienced, and treatment response and outcomes may be compromised. We report an atypical case of new onset diabetes with severe DKA and underlying severe sepsis, which responded poorly to traditional therapy resulting in maximal intensive care management including mechanical ventilation, inotropes, extracorporeal membrane oxygenation (ECMO) for cardiorespiratory support, and kidney replacement therapy.