10 - 40% children with newly diagnosed diabetes are admited to hospital in a state of diabetic ketoacidosis the mortality of which in advanced countries is 1 - 2%. Successful control of the acute condition depends on adequate insulin and potassium doses in a continuous infusion and prevention of cerebral oedema. The need of insulin and potassium during the initial 48 hours of treatment was analyzed in 26 children with a recent manifestation of diabetes type 1. The children age was 1.0 - 16.5 years (median 10.2). Treatment was administered according to a standard protocol. The baseline blood sugar level of the patients was 13.9 - 43.0 mmol/l (median 27.1), the potassium level 3.2 - 6.8 mmol/l (median 4.6), the CHO3- level 4.7 - 30.5 mmol/l (median 16.2) and HbA1c 7.1 - 14.5% (median 9.4). The insulin requirement remained stable (1st to 24th and 25th to 48th hour of treatment - median 0.06 I.V./kg/hour). The potassium requirement declined significantly from 4.6 mmol/kg/24 hours (median) during the 1st to 24th hour to 3.6 mmol/kg/hours during the 25th to 48th hour of treatment. The individual insulin requirement was influenced by the severity of the baseline acidosis which was expressed by the HCO3- level (1st to 24th hour, r=0.71, p<0.0001; 25th to 48th hour, r=0.60, p=0.001), during the first 24 hours also by the baseline potassium (r=0.51, p=0.007) and blood sugar level (r=0.45, p=0.02). Statistical evaluation revealed that the insulin requirement during the first 48 hours of treatment is in more than 50% predictable from the baseline laboratory values. Analysis of the potassium requirement revealed a higher requirement in younger children during the 1st to 12th hour of treatment (r=0.55, p=0.003) and a greater requirement in children with a higher HbA1c level during the 25th to 48th hour of treatment (r=0.40, p=0.04). This indicates the influence of the severity and duration of hyperglycaemia on general potassium depletion. The application of these findings in the elaboration of the therapeutic plan can help more rapid and more effective repair of this serious metabolic disorder.

        Key words: diabetes mellitus type 1, diabetic ketoacidosis, treatment, children, insulin, potassium