Overview of the diagnosis and management of diabetic ketoacidosis.
Diabetic ketoacidosis is an acute complication of diabetes mellitus that can be life-threatening if not treated properly. Once thought to occur only in patients with type 1 diabetes, diabetic ketoacidosis has been also observed in patients with type 2 diabetes under certain conditions. The basic underlying mechanism for diabetic ketoacidosis is insulin deficiency coupled with elevated levels of counter-regulatory hormones, such as glucagon, cortisol, catecholamines, and growth hormone. Diabetic ketoacidosis can be the initial presentation of diabetes mellitus or precipitated in known diabetic patients by many factors, most commonly infection. The management of diabetic ketoacidosis involves careful clinical evaluation, correction of metabolic abnormalities, identification and treatment of precipitating and comorbid conditions, appropriate long-term treatment of diabetes, and plans to prevent recurrence. Certain areas need further research, such as indications for the use of bicarbonate and phosphates and the use of intravenous rapid-acting insulin.
Eledrisi
Mohsen S
MS
Department of Internal Medicine, King Abdulaziz National Guard Medical Center, King Faisal Specialist Hospital, Alahsa, Saudi Arabia. eledrisim@ngha.med.sa
Alshanti
Mohammed S
MS
Shah
M Faiq
MF
Brolosy
Basem
B
Jaha
Nermeen
N
D000136:Acid-Base Equilibrium / Q000502:physiology; D001639:Bicarbonates / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D016883:Diabetic Ketoacidosis / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D004573:Electrolytes / Q000627:therapeutic use; D005440:Fluid Therapy; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use
D001639:Bicarbonates; D001786:Blood Glucose; D004573:Electrolytes; D007004:Hypoglycemic Agents; D007328:Insulin