DKA management
Is anyone out there (most specifically from a pediatric setting) familiar with your DKA management and protocols for newly diagnosed diabetics?
Looking specifically for what glucose values the patient treatment is being based on. I've come to find out that they are relying heavily on the glucometer values, even in the first 12 hours of the admission in which peds DKAs can be very fragile and critical with glucoses all over the map. I don't think this is best practice as a glucose meter is not a diagnostic instrument. We've recently had a couple instances that really highlight this in which the lab values and glucose meter values did not correlate at all until the patient's acidosis had improved about 12 hours into admission.
This was on a 14 month old which is extremely young for presentation of Type I so I'm wondering if it's this specific patient/age? We are going to move forward pulling data on our most recent DKAs but wondered what experience you all had.
For reference, we use the Nova meter which is cleared for use in critically ill. We do not allow capillary specimens in our ICUs - only venous or art.
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