Data from a retrospective study shows that higher BMI and blood urea nitrogen levels are related with an increased risk for death from diabetic ketoacidosis among children. Researchers analysed medical charts and autopsy reports and collected data on sample and treatment characteristics, serum chemistries, and histological or radiographic evidence for cerebral edema of all children aged younger than 19 years who presented to the hospital with diabetic ketoacidosis who survived.

Suresh Havalad, MD (Associate Professor of Paediatrics at Chicago Medical School and Division Director of Pediatric Critical Care at Advocate) analyzed data for all children aged younger than 19 years who presented to the hospital with diabetic ketoacidosis who survived (controls, n=122) and died (cases, n=10) during a 6-year period.
Case-control comparisons were conducted and selected clinical parameters, including serum glucose, creatinine, blood urea nitrogen (BUN), calculated osmolality and BMI were observed.

Death from diabetic ketoacidosis was significantly associated with BMI, BUN, glucose, creatinine and calculated osmolality in univariate analysis. In multivariate model, however, significant predictors of mortality were only BMI and BUN.

Using established criteria for obesity and azotemia, children with diabetic ketoacidosis were more likely to die if BMI was 30 and BUN was 40 mg/dL .