• Yan-Yan Hu, Gui-Mei Li, and Wei Wang.
• Department of Pediatrics, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China. E-mail. hyanyansmile@hotmail.com.
• Saudi Med J. 2015 Feb 1; 36 (2): 243247243-7.

ObjectivesTo investigate characteristics of euthyroid sick syndrome (ESS) in children with diabetic ketoacidosis (DKA).MethodsThis retrospective study was carried out between May 2010 and April 2013 at the Pediatric Department of Shandong Provincial Hospital, Shandong University, Shandong, China. Diabetic ketoacidosis children were divided into 2 groups: euthyroidism (group one, n=30) and ESS (group 2, n=40). C-peptide, glycosylated hemoglobin (HbA1c), bicarbonate, anion gap (AG), free triiodothyronine (FT3), free thyroxine (FT4), and thyrotropin (TSH) levels were measured before and after 7 days of insulin treatment. Daily blood glucose (BG) profiles were recorded.ResultsGlycosylated hemoglobin, AG, the mean daily BG, and fasting blood glucose levels were higher, and bicarbonate, FT3, FT4, and TSH levels were lower in group 2 than in group one (all p<0.05). Free triiodothyronine (r=-0.593, p<0.001) and FT4 (r=-0.402, p=0.001) were negatively correlated with HbA1c. Free triiodothyronine (r=-0.438, p<0.001) and FT4 (r=-0.505, p<0.001) were negatively correlated with AG, and FT3 (r=0.503, p<0.001) and FT4 (r=0.448, p<0.001) were positively correlated with bicarbonate.ConclusionDiabetic ketoacidosis children with ESS have poor diabetic control. Free thyroid hormones are associated with the severity of DKA.

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