Successful treatment of type 1 diabetes and seizures with combined ketogenic diet and insulin.

Abstract:

:Diabetic ketoacidosis (DKA) is a life-threatening condition and a major cause of morbidity and mortality in children with type 1 diabetes mellitus. The deficiency of insulin leads to metabolic decompensation, causing hyperglycemia and ketosis that resolves with the administration of insulin and fluids. However, an induced state of ketosis is the basis for the success of the ketogenic diet (KD), which is an effective therapy for children with intractable epilepsy. We report the case of a 2-year-old girl who presented to the emergency department with 1-week history of decreased activity, polyuria, and decreased oral intake. Her past medical history was remarkable for epilepsy, for which she was started on the KD with a significant improvement. Her laboratory evaluation was compatible with DKA, and fluids and insulin were given until correction. Because of concerns regarding recurrence of her seizures, the KD was resumed along with the simultaneous use of insulin glargine and insulin aspart. Urine ketones were kept in the moderate range to keep the effect of ketosis on seizure control. Under this combined therapy, the patient remained seizure-free with no new episodes of DKA.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Aguirre Castaneda RL,Mack KJ,Lteif A

doi

10.1542/peds.2011-0741

subject

Has Abstract

pub_date

2012-02-01 00:00:00

pages

e511-4

issue

2

eissn

0031-4005

issn

1098-4275

pii

peds.2011-0741

journal_volume

129

pub_type

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