Optic UltrasoundDKA Optic Ultrasound

Inclusion Criteria:

Ages 7-18 years English speaking

DKA group recruited from Children's ED. Criteria for DKA:

1. Hyperglycemia >200 mg/dL AND
2. Venous pH <7.30 AND/OR
3. Bicarbonate level <15 AND
4. Either positive urine or serum ketones

T1DM and hyperglycemia without criteria for DKA (recruited from Children's ED). Criteria for inclusion:

1. Hyperglycemia (>200 mg/dL) not meeting above criteria for DKA

Well-controlled T1DM control group (recruited from Children's Endocrinology Clinic). Criteria for inclusion:

1. Hemoglobin A1c <8% at time of clinic visit
2. No previous episodes of DKA other than at the time of diagnosis
3. Has never had a documented hemoglobin A1c >10%

Exclusion Criteria:

DKA and patients with T1DM and hyperglycemia without criteria for DKA

1. Treatment with more than 10 mL/kg IV fluids prior to transfer from outside hospital
2. Treatment with insulin prior to transfer from outside hospital
3. Patients with type 2 DM
4. Patients with Hyperosmolar Hyperglycemic Nonketotic State
5. Underlying neurologic condition predisposing to changes in ICP (hydrocephalus, ventriculoperitoneal shunt, Chiari I malformation, Chiari II malformation, pseudotumor cerebri, brain tumor)
6. Underlying condition predisposing to changes in intraocular pressure (glaucoma, eye trauma)

Well-controlled T1DM group with poorly controlled disease, defined as:

1. Hemoglobin A1c >8% OR
2. >1 previous episode of DKA, including DKA at time of diagnosis OR
3. Hemoglobin A1c documented >10% any time in the past