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Increased hyperglycaemia and hepatic ketogenesis lead to osmotic diuresis, dehydration and tissue hypoxia. Acute complications of <jats:styled-content style=\"fixed-case\">DKA<\/jats:styled-content> include cerebral oedema, which may be compounded by malnutrition, parasitic and microbial infections with rampant tuberculosis and <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>. Overlapping symptoms of these conditions and misdiagnosis of <jats:styled-content style=\"fixed-case\">DKA<\/jats:styled-content> contribute to increased morbidity and mortality. Inability of the patients to afford insulin treatment leads to poor glycemic control as some patients seek alternative treatment from traditional healers or use herbal remedies further complicating the disease process. Standard treatment guidelines for <jats:styled-content style=\"fixed-case\">DKA<\/jats:styled-content> currently used may not be ideal as they are adapted from those of the developed world. Children presenting with suspected <jats:styled-content style=\"fixed-case\">DKA<\/jats:styled-content> should be screened for comorbidities which may complicate fluid and electrolyte replacement therapy protocol. Patient rehabilitation should take into account concurrent treatment for infectious conditions to avoid possible life\u2010threatening drug interactions. We recommend that health systems in sub\u2010<jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>aharan <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>frica leverage the <jats:styled-content style=\"fixed-case\">E<\/jats:styled-content>xpanded <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>mmunization <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>rogramme or <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">AIDS<\/jats:styled-content> programmes, which are fairly well entrenched to support diabetes services.<\/jats:p>","DOI":"10.1111\/tmi.12195","type":"journal-article","created":{"date-parts":[[2013,10,12]],"date-time":"2013-10-12T01:06:33Z","timestamp":1381539993000},"page":"1357-1364","source":"Crossref","is-referenced-by-count":29,"title":["Diabetic ketoacidosis: an overlooked child killer in sub\u2010<scp>S<\/scp>aharan <scp>A<\/scp>frica?"],"prefix":"10.1111","volume":"18","author":[{"given":"A. 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