What does this research mean for the field?

Pediatric diabetic ketoacidosis requiring PICU admission has low mortality but high morbidity, particularly acute kidney injury, with complications strongly associated with admission acid-base and glycemic parameters, while newly diagnosed and previously known diabetes patients show similar overall clinical outcomes despite some biochemical differences. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate complications and clinical outcomes among pediatric patients admitted to the intensive care unit with diabetic ketoacidosis, comparing newly diagnosed cases with previously known diabetes.

September 2, 2026BMC Endocrine DisordersOpen Access

Clinical factors associated with pediatric intensive care unit outcomes in children admitted with diabetic ketoacidosis: a systematic review and meta-analysis comparing newly diagnosed and previously known diabetes

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Authors

HSHedieh SoltaniJahrom University of Medical Sciences MGMohammad Sadra Gholami-ChahkandGolestan University AEAlireza EskandariJahrom University of Medical Sciences

Discussion

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Implication

Systematic review and meta-analysis reveals low mortality but high complication rates in pediatric diabetic ketoacidosis, highlighting acid-base status as a key predictor of cerebral edema.

Key Points

To evaluate complications and clinical outcomes among pediatric patients admitted to the intensive care unit with diabetic ketoacidosis, comparing newly diagnosed cases with previously known diabetes.
Systematic review and meta-analysis of 41 studies comprising 3,792 pediatric patients (<21 years old) admitted to the pediatric intensive care unit for diabetic ketoacidosis across PubMed, Web of Science, Embase, and Scopus through July 2025.
Extracted demographic, clinical, laboratory, and outcome variables, using meta-regression to identify factors associated with major complications.
Severe diabetic ketoacidosis occurred in 53.7% of patients and overall pooled mortality was 1%, with acute kidney injury emerging as the most frequent complication at 30%.
Meta-regression demonstrated that higher HbA1c and lower pH, bicarbonate, and PCO2 levels were significantly associated with an increased incidence of cerebral edema.
Newly diagnosed patients exhibited significantly higher admission bicarbonate, potassium, and PCO2 alongside lower blood ketone levels and shorter insulin infusion durations compared to previously diagnosed patients, without significant differences in intensive care length of stay.

Cite This Study

Soltani et al. (2026) studied this question.

synapsesocial.com/papers/6a97e275c562ede874ec6973 https://doi.org/10.1186/s12902-026-02517-2

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Implication

Systematic review and meta-analysis reveals low mortality but high complication rates in pediatric diabetic ketoacidosis, highlighting acid-base status as a key predictor of cerebral edema.

Clinical factors associated with pediatric intensive care unit outcomes in children admitted with diabetic ketoacidosis: a systematic review and meta-analysis comparing newly diagnosed and previously known diabetes

Discussion

Member takes

Implication

Key Points

Cite This Study

Clinical factors associated with pediatric intensive care unit outcomes in children admitted with diabetic ketoacidosis: a systematic review and meta-analysis comparing newly diagnosed and previously known diabetes

Discussion

Member takes

Implication

Key Points

Cite This Study

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