• Abdulrahman Özel, Esra Ecem Erol, Servet Yüce, Övgü Büke, Feride Tahmiscioglu, and Meltem Erol.
• Bagcılar Training and Research Hospital, Department of Pediatrics, Pediatric Intensive Care Unit, Health Sciences University Turkey, Istanbul, Turkey. dr.abdulrahman.ozel@gmail.com.
• Wien. Klin. Wochenschr. 2024 Sep 11.

IntroductionSerum lactate levels have been recognized as a robust marker for predicting disease severity and survival in many critically ill children but consensus is lacking regarding its utility in diabetic ketoacidosis. This study aimed to investigate the relationship between initial lactate levels and disease severity in pediatric patients presenting with diabetic ketoacidosis.MethodsThis single-center retrospective descriptive study involved pediatric patients with diabetic ketoacidosis in the pediatric emergency department between January 2022 and April 2023. Patients were diagnosed using the International Society for Pediatric and Adolescent Diabetes 2022 guidelines.ResultsAmong the 112 patients included in the study, 41 (36.6%) were classified as mild, 42 (34.8%) as moderate and 32 (28.6%) as severe acidosis. A statistically significant difference was observed between the time to resolution and clinical severity of diabetic ketoacidosis (p < 0.001). Elevated lactate levels of 2.5 mmol/L or above were detected in 37.5% (42/112) of our patients and a significant increase in clinical severity was observed as lactate levels increased (p < 0.001). Correlation analysis revealed no significant relationship between lactate levels and time to resolution of diabetic ketoacidosis or length of intensive care unit stay. Multivariate analysis demonstrated a significant association between lactate levels and severity of acidosis (p: 0.046).ConclusionAlthough there is an association between the severity of acidosis and lactate levels in diabetic ketoacidosis, contrary to expectations, this relationship was not found to be associated with adverse outcomes. An important point not to be overlooked by pediatricians is that elevated lactate levels in diabetic ketoacidosis may not always herald poor outcomes.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.

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