Arch Dis Child 89:188-194 doi:10.1136/adc.2003.044875
  • Acute paediatrics

ESPE/LWPES consensus statement on diabetic ketoacidosis in children and adolescents

  1. D B Dunger1,
  2. M A Sperling2,
  3. C L Acerini1,
  4. D J Bohn2,
  5. D Daneman2,
  6. T P A Danne1,
  7. N S Glaser2,
  8. R Hanas1,
  9. R L Hintz2,
  10. L L Levitsky2,
  11. M O Savage1,
  12. R C Tasker1,
  13. J I Wolfsdorf2
  1. 1European Society for Paediatric Endocrinology (ESPE)
  2. 2Lawson Wilkins Pediatric Endocrine Society (LWPES)
  1. Correspondence to:
    Prof. D B Dunger
    University of Cambridge, Department of Paediatrics, Addenbrooke’s Hospital, Level 8, Box 116, Cambridge CB2 2QQ, UK;
  • Accepted 27 October 2003


Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with type 1 diabetes mellitus (TIDM). Mortality is predominantly related to the occurrence of cerebral oedema; only a minority of deaths in DKA are attributed to other causes. Cerebral oedema occurs in about 0.3–1% of all episodes of DKA, and its aetiology, pathophysiology, and ideal method of treatment are poorly understood. There is debate as to whether physicians treating DKA can prevent or predict the occurrence of cerebral oedema, and the appropriate site(s) for children with DKA to be managed. There is agreement that prevention of DKA and reduction of its incidence should be a goal in managing children with diabetes.


  • Participants: Carlo L Acerini, Cambridge UK; Dorothy J Becker, Pittsburgh, USA; Desmond Bohn, Toronto, Canada; Stuart J Brink, Waltham, USA; Francesco Chiarelli, Chieti, Italy; Maria Craig, Kogarth, Australia; Gisela Dahlquist, Umea, Sweden; Denis Daneman, Toronto, Canada; Thomas Danne, Hanover, Germany; David B Dunger, Cambridge, UK; Julie A Edge, Oxford, UK; Irma Fiordalisi, Greenville, USA; Nicole S Glaser, Sacramento, USA; John Gregory, Cardiff, UK; Mitchell Halperin, Toronto, Canada; Ragnar Hanas, Uddevalla, Sweden; Glen Harris, Greenville, USA; Morey W Haymond, Houston, USA; Ray L Hintz, Stanford, USA; Carol Inward, Cardiff, UK; Chris Kelnar, Edinburgh, UK; Wieland Kiess, Leipzig, Germany; Mikael Knip, Helinski, Finland; Elliot J Krane, Stanford, USA; Nathan Kuppermann, Sacramento, USA; Sarah Muirhead Lawrence, Ottawa, Canada; Lynne Levitsky, Boston, USA; Marc Maes, Brussels, Belgium; Henrik Mortensen, Glostrup, Denmark; Andrew Muir, Augusta, USA; Andreas Neu, Tubingen, Germany; Jose Ramet, Brussels, Belgium; Robert Rapaport, New York, USA; Arleta Rewers, Denver, USA; Marian J Rewers, Denver, USA; Arlan L Rosenbloom, Gainesville, USA; Martin O Savage, London, UK; Mark A Sperling, Pittsburgh, USA; Peter Swift, Leicester, UK; William V Tamborlane, New Haven, USA; Robert C Tasker, Cambridge, UK; Nadia Tubiana-Rufi, Paris, France; Maurizio Vanelli, Parma, Italy; Diane K Wherrett, Toronto, Canada; Neil H White, St Louis, USA; Joseph I Wolfsdorf, Boston, USA.

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