Page 468 - Manual de Urgencias Pediatría Virgen del Rocío
P. 468
Partes 425-584 4/7/07 11:02 Página 453
Diabetes mellitus tipo 1. Complicaciones agudas 453
• Clínica: arritmias, parada cardíaca, debilidad de la musculatura respiratoria, etc.
• Diagnóstico:
– Monitorización de los niveles de potasio.
– Electrocardiograma.
• Prevención: reposición adecuada de las pérdidas.
• Tratamiento: administración de potasio.
Neumonía por aspiración
• Se puede evitar mediante la colocación de sonda nasogástrica en niños con
vómitos y alteración del nivel de conciencia.
Otras complicaciones
Requieren tratamiento específico.
• Dolor abdominal persistente por inflamación hepática/gastritis/retención urina-
ria. Cuidado con la apendicitis.
• Neumotórax, neumomediastino.
• Edema pulmonar.
• Infecciones inusuales.
BIBLIOGRAFÍA
1. Northam EA,Anderson PJ, Jacobs R, et al. Neuropsychological profiles of children with type 1 diabe-
tes 6 years after disease onset. Diabetes Care 2001;24:1541-1546.
2. ISPAD Consensus Guidelines for the Manegement of Type 1 Diabetes Mellitus in Children and Ado-
lescents. Ed PGF Swift. Publ Medforum, Zeist, Netherlands 2000: 77-82.
3. Davis EA, Keating B, Byrne GC, y cols. Impact of improved glycaemic control on rates of hypoglycae-
mia in insulin dependent diabetes mellitus.Arch Dis Child 1998;78: 111-115.
4. Hartemann-Heurtier a, Sachon C, Masseboeuf N, et al. Functional intensified insulin therapy with
short-acting insulin analog: effects on HbA1c and frequency of severe hypoglycemia.An observa-
tional cohort study. Diabetes Metab 2003;29:53-57.
5. Hanas R,Adolfsson P. Insulin pumps in pediatric routine care improve long-term metabolic control
without increasing the risk of hypoglycemia. Pediatric Diabetes 2006;7: 25-31.
6. Dunger DB, Sperling MA,Acerini CL y cols. European Society for Paediatric Endocrinology/Lawson
Wilkins Pediatric Endocrine Society Consensus Statement on Diabetic Ketoacidosis in Children
and Adolescents. Pediatrics 2004;113:e133-e140.
7. Monroe KW, King W,Atchison JA: Use of PRISM scores in triage of pediatric patients with diabetic
ketoacidosis.American Journal of Managed Care 1997;3:253-258.
8. Wolfsdorf J, Glaser N, Sperling MA. Diabetic ketoacidosis in infants, children, and adolescents. A
consensus statement from the American Diabetes Association. Diabetes Care 2006;29:1150-1159.
9. Wallace T M, Matthews D R. Recent advances in the monitoring and management of diabetic keto-
acidosis. Q J Med 2004;97:773-780.
10. Glaser N, Barnett P, McCaslin I y cols. Risk factors for cerebral edema in children with diabetic keto-
acidosis. NEJM 2001;344:264-269.
11. Marcin JP, Glaser N, Barnett P y cols. Factors associated with adverse outcomes in children with dia-
betic ketoacidosis-related cerebral edema. J Pediatr 2002;141:793-797.
12. Muir AB, Quisling RG,Yang MCK, Rosenbloom AL. Cerebral edema in Childhood Diabetic Ketoaci-
dosis.Natural history,radiographic findings and early identification.Diabetes Care 2004;27:1541-1546.
Diabetes mellitus tipo 1. Complicaciones agudas 453
• Clínica: arritmias, parada cardíaca, debilidad de la musculatura respiratoria, etc.
• Diagnóstico:
– Monitorización de los niveles de potasio.
– Electrocardiograma.
• Prevención: reposición adecuada de las pérdidas.
• Tratamiento: administración de potasio.
Neumonía por aspiración
• Se puede evitar mediante la colocación de sonda nasogástrica en niños con
vómitos y alteración del nivel de conciencia.
Otras complicaciones
Requieren tratamiento específico.
• Dolor abdominal persistente por inflamación hepática/gastritis/retención urina-
ria. Cuidado con la apendicitis.
• Neumotórax, neumomediastino.
• Edema pulmonar.
• Infecciones inusuales.
BIBLIOGRAFÍA
1. Northam EA,Anderson PJ, Jacobs R, et al. Neuropsychological profiles of children with type 1 diabe-
tes 6 years after disease onset. Diabetes Care 2001;24:1541-1546.
2. ISPAD Consensus Guidelines for the Manegement of Type 1 Diabetes Mellitus in Children and Ado-
lescents. Ed PGF Swift. Publ Medforum, Zeist, Netherlands 2000: 77-82.
3. Davis EA, Keating B, Byrne GC, y cols. Impact of improved glycaemic control on rates of hypoglycae-
mia in insulin dependent diabetes mellitus.Arch Dis Child 1998;78: 111-115.
4. Hartemann-Heurtier a, Sachon C, Masseboeuf N, et al. Functional intensified insulin therapy with
short-acting insulin analog: effects on HbA1c and frequency of severe hypoglycemia.An observa-
tional cohort study. Diabetes Metab 2003;29:53-57.
5. Hanas R,Adolfsson P. Insulin pumps in pediatric routine care improve long-term metabolic control
without increasing the risk of hypoglycemia. Pediatric Diabetes 2006;7: 25-31.
6. Dunger DB, Sperling MA,Acerini CL y cols. European Society for Paediatric Endocrinology/Lawson
Wilkins Pediatric Endocrine Society Consensus Statement on Diabetic Ketoacidosis in Children
and Adolescents. Pediatrics 2004;113:e133-e140.
7. Monroe KW, King W,Atchison JA: Use of PRISM scores in triage of pediatric patients with diabetic
ketoacidosis.American Journal of Managed Care 1997;3:253-258.
8. Wolfsdorf J, Glaser N, Sperling MA. Diabetic ketoacidosis in infants, children, and adolescents. A
consensus statement from the American Diabetes Association. Diabetes Care 2006;29:1150-1159.
9. Wallace T M, Matthews D R. Recent advances in the monitoring and management of diabetic keto-
acidosis. Q J Med 2004;97:773-780.
10. Glaser N, Barnett P, McCaslin I y cols. Risk factors for cerebral edema in children with diabetic keto-
acidosis. NEJM 2001;344:264-269.
11. Marcin JP, Glaser N, Barnett P y cols. Factors associated with adverse outcomes in children with dia-
betic ketoacidosis-related cerebral edema. J Pediatr 2002;141:793-797.
12. Muir AB, Quisling RG,Yang MCK, Rosenbloom AL. Cerebral edema in Childhood Diabetic Ketoaci-
dosis.Natural history,radiographic findings and early identification.Diabetes Care 2004;27:1541-1546.
