Cerebral oedema is the most common cause of mortality and morbidity during the first day of conventional treatment for diabetic ketoacidosis in paediatric patients.

The danger of DKA does not end when treatment begins. During the first day of conventional therapy, pediatric patients face a silent, terrifying threat: cerebral oedema, or brain swelling. This occurs because water, which makes up about eighty percent of brain weight, shifts rapidly into the brain cells. It is driven by changes in blood osmolality as therapies alter the fluid compartments. It remains the most common cause of death during early DKA treatment in children.