Changes in hematological parameters during first days of diabetic ketoacidosis treatment in children with type 1 diabetes mellitus

Abstract

Background. Diabetic ketoacidosis (DKA) is a life-threatening complication of newly diagnosed type 1 diabetes (T1DM) and is associated with severe dehydration. The aim of the study was to evaluate the changes in hematological parameters (RBC, Hct, Hb, MCV, PLT, WBC) and their correlations with acidosis level and dehydration during ketoacidosis treatment. Methods. The study group consisted of 262 children with newly diagnosed type 1 diabetes. Clinical data were collected from hospital discharge charts. Data considering hematological parameters were collected from two timepoints: first at admission and second up to 6 days since admission. Results. Ketoacidosis was present in 76 patients (29.01%). The DKA group had significantly higher values of baseline RBC (p = 0.0026), Hct (p = 0.0019), Hb (p = 0.0235), PLT (p = 0.0427) and WBC count (p < 0.0001) vs. patients without DKA. Interestingly, baseline MCV level was similar between the groups (p = 0.9869). During the first days of diabetes treatment, all hematological parameters such as RBC, Hct, Hb, PLT and WBC significantly decreased in both groups (all p values < 0.0001), while MCV significantly increased after treatment (p < 0.0001). However, the latter was evident only in no-DKA group. Changes in all hematological parameters correlated positively with pH (all R > 0.3 and all p values < 0.05) in DKA group but not in no-DKA group. However, weak, positive correlations at the margin of statistical significance with pH were observed for changes in PLT (p = 0.0609) and WBC (p = 0.0811) in no-DKA group. Conclusion. Monitoring dynamics of hematological parameters at T1DM diagnosis may be useful in estimating patients' hydration status.