Diabetic Ketoacidosis

Future research recommendations for the management of DKA in children in the Egyptian context could include:

·   Future researches should be directed to efficacy of the fluid protocol and the impact of application of the guidelines on the outcome of DKA

These recommendations aim to address specific challenges and characteristics of the Egyptian context, potentially leading to more effective prevention and management strategies for DKA. in children.

➡️Challenges

·  Presence of trained staff (physicians and nurses) skilled to manage DKA cases

·  availability of well-equipped ICU

· Access to a laboratory that can provide frequent and timely Lab results.

·  distribution of the guidelines to medical care units.

·  Lack of trained nurses dealing with emergency cases (unexperienced with IV canulation, fluids preparation)

· Absence of laboratory providing frequent timely results

·   unavailability of some preparations like: phosphate to correct hypophosphatemia, half normal saline to be used in hyperosmolarity, and mannitol or hypertonic saline.

Strengthen the evidence base of the next update of this guideline by generating GRADE summary of finding tables, evidence profiles, and EtD frameworks.