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The main aim in the treatment of diabetic ketoacidosis is to replace the lost fluids and electrolytes while suppressing the high blood sugars and ketone production with insulin. Admission to an intensive care unit (ICU) or similar high-dependency area or ward for close observation may be necessary.
Ketoacidosis is a metabolic state caused by uncontrolled production of ketone bodies that cause a metabolic acidosis. While ketosis refers to any elevation of blood ketones, ketoacidosis is a specific pathologic condition that results in changes in blood pH and requires medical attention.
Diabetic ketoacidosis (DKA) is one of the life-threatening severe complications of diabetes that demands immediate attention and intervention. [7] It is considered a medical emergency and can affect both patients with T1D (type 1 diabetes) and T2D (type 2 diabetes), but it is more common in T1D. [8]
Ketoacidosis is most commonly caused by a deficiency of insulin in type 1 diabetes or late stage type 2 diabetes but can also be the result of chronic heavy alcohol use, salicylate poisoning, or isopropyl alcohol ingestion. [1] [2] Ketoacidosis causes significant metabolic derangements and is a life-threatening medical emergency. [2]
Infections, stroke, trauma, certain medications, heart attacks [4] Diagnostic method: Blood tests [2] Differential diagnosis: Diabetic ketoacidosis [2] Treatment: Intravenous fluids, insulin, low molecular weight heparin, antibiotics [3] Prognosis ~15% risk of death [4] Frequency: Relatively common [2]
Untreated ketoacidosis can rapidly progress to loss of consciousness, coma, and death. [29] The percentage of children whose type 1 diabetes begins with an episode of diabetic ketoacidosis varies widely by geography, as low as 15% in parts of Europe and North America, and as high as 80% in the developing world. [29]
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