Neuron-specific enolase is a sensitive marker of neuronal damage in various neurologic disorders. This study aimed to measure
serum neuron-specific enolase levels at different time points and severities of diabetic ketoacidosis. This study included 90
children (age 9.2 + 3.4 years) with diabetic ketoacidosis. Neuron-specific enolase was measured at 3 time points (baseline and
after 12 and 24 hours of starting treatment). Among patients, 74.4% had diagnosis of new diabetes, 60% had Glasgow Coma Scale
score <15, and 75.6% had moderate/severe diabetic ketoacidosis. Compared with controls (n ¼ 30), children with diabetic
ketoacidosis had higher neuron-specific enolase levels at the 3 time points (P ¼ .0001). In multiple regression analysis, the factors
associated with higher neuron-specific enolase levels were younger age, higher glucose, lower pH, and bicarbonate values. This
study indicates that serum neuron-specific enolase is elevated in diabetic ketoacidosis and correlated with the severity of
hyperglycemia, ketosis, and acidosis. This study indicates that diabetic ketoacidosis may cause neuronal injury from which the
patients recovered partially but not completely.