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Baljinder Kaur, Speaker at Pediatrics Conferences
GMC&RH, India


Type 1 diabetes  mellitus is an immune mediated disease that triggers, as a final  consequence, the complete or partial loss of pancreatic cells, decreasing  the production  of endogenous  insulin,  and  thus  generating  a  dependence of the affected patient on  the exogenous insulin  administration to maintain adequate energy production.

Diabetic ketoacidosis is a metabolic disorder, with a triad consisting of hyperglycemia,ketosis  and acidemia. Genetics plays  a role in progression to clinical disease. Class II HLA genes are the ones most strongly associated with the risk of type 1 diabetes mellitus. Some of  the known associations include HLA DR3/4- DQ2/8 genotype.  Pathophysiology of diabetic  ketoacidosis  involves  autoimmune  destruction of beta cells in the pancreas and the subsequent lack of  insulin. Severe hyperglycemia and systemic inflammation associated  with DKA have been shown to further deplete functional pancreatic islets.

Mean age of presentation of diabetic ketoacidosis in our set up was 11.3 years n=11.3). Number of female cases outnumbers the number of male cases  (55.88% vs 44.11%). RBS levels were on the higher side in all the presenting cases(n=366 mg/dl) and  corresponding HbA1c levels were also on the higher side(n=10.8). 64.70% children of diabetic ketoacidosis presented to us with respiratory distress  as their presenting complaint. This is because most of the patients who came to  our set up belong to rural background with ignorant attitude. These people ignore  vague symptoms like nausea and vomiting, thus seek medical advice when the  child develops respiratory distress. Followed by fever,polyuria and polydipsia,  pain abdomen and least common presenting complaint was vomiting.

34 children presenting to intensive care department of pediatrics,  government medical college and rajindra hospital patiala with diabetic ketoacidosis with age ranging from 2 years to 18 years were subjects of study. For the purpose of study, children were divided into  age group of 2-5 years,>5-10 years , >10-18 years respectivelyName,  age, gender, address,  clinical examination and  serial lab profile,  response to treatment was recorded on a pre-designed and pre-tested  proforma. Data so obtained was subjected to analysis for the purpose  of study.


Dr. Baljinder studied Paediatrics  at the Baba Farid University , Punjab and graduated as MD in 1993. She then joined as medical officer in Punjab and did multiple research work during her numerous postings. After one year postdoctoral fellowship supervised by Dr RS Malhotra at the government Medical College and Rajindra Hospital, Patiala she obtained the position of an Assistant  Professor at GMC&RH Patiala. She has published more than 70 research articles in SCI(E) journals.