QTc and QTd in Children with Type 1 Diabetes Mellitus during Diabetic Ketoacidosis

Abstract

Cardiac arrest has been described in children with diabetic ketoacidosis (DKA). Aim . To evaluate QTc and QTd in type 1 diabetic children with DKA. Methods . Twelve-lead ECG was done to 30 type 1 diabetic children with DKA at presentation and recovery. Corrected QT interval and QT dispersion (QTd) were assessed. Results . QTc and QTd mean values were significantly decreased in patients after than before DKA recovery ( P < 0.01 ). Procedure . Sixteen patients (53, 3%) had prolonged QTc during DKA (range 451–538 ms) that dropped to one patient after recovery, his QTc (453 ms) returned to normal 5 days after hospital discharge. Nineteen patients (63.3%) had prolonged QTd (>50 ms) that dropped to three after recovery. The fact that three patients had normal QTc but prolonged QTd increases the privilege of QTd over QTc as a better marker for cardiac risk in those patients. Anion gap was significantly associated with QTc and QTd prolongation ( P < 0.0001 ). Patients had no electrolyte abnormalities or hypoglycemia to account for QTc or QTd prolongation. Conclusion . Prolonged QTc and QTd frequently occur in DKA positively correlated to ketosis. Cardiac monitoring for patients with DKA is mandatory.