Background and aim: Previously we reported significantly higher plasma values of the essential fatty acids but signifi-cantly lower values of their longer-c hain metabolites in diabetic children than in healthy controls. Here, we report data on the acute effect of diabetic ketoacidosis (DKA) on the fatty acid compos ition of plasma lipids. Methods: Diabetic children (n = 9; age: 16.1 [3.3] y; du ration of diabetes: 5.0 [5.3.] y; daily insulin dose: 0.87 [0.66] unit/kg body w eight/d; glycated haemoglobin: 13.4 [2.8] %; median [IQR]) were investigated at admission for DKA (during DKA) and at the end of the treatment of DKA (after DK A). Fatty acid composition of plasma lipid classes was determined by high-resol ution capillary gasliquid chromatography. Results: Blood glucose (27.0 [8.5] vs 6.5 [1.6] mmol/l), pH (7.28 [0.35] vs 7.36 [0.06]) and base excess (-8.9 [15.1] vs -2.2 [6.3] mmol/l) were grossly abnormal during but not after DKA. Values o f linoleic acid were significantly lower after than during DKA (non-esterifed f atty acids (NEFA): 15.55 [1.47] vs 12.27 [5.74]%wt/wt; triacylglycerols (TG): 2 0.84 [9.23] vs 17.40 [5.78]; p < 0.05). In contrast, values of gamma-linolenic acid (NEFA: 0.87 [0.54] vs 2.34 [1.85]; p< 0.05) and arachidonic acid (TG: 1.37 [0.71] vs 1.74 [0.57];< 0.05) were significantly lower during than after DKA. Th e product/substrate ratios for delta-6 desaturation were significantly lower du ring than after DKA.Conclusion: Successful treatment of diabetic ketoacidosis is associated with a significant increase of long-chain polyunsaturated fatty aci d values in blood plasma in diabetic children. This observation suggests that di sturbances of essential fatty acid metabolism in diabetic children are related n ot only to diet but to hypoinsulinaemia as well.
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