Safety and efficacy of an algorithm-based protocol in the management of diabetic ketoacidosis.
OBJECTIVE
To determine the efficacy of an algorithm-based protocol to manage diabetic ketoacidosis (DKA).


METHODS
Our study is a retrospective chart review of patients with DKA managed before and after implementation of an algorithm-based DKA protocol at a tertiary care hospital.


RESULTS
There were 88 patients managed 1 year prior (control group) and 70 patients managed one year after (study group) implementation of the algorithm-based DKA protocol. The DKA resolution time was significantly shorter (11.5 [8.1 to 17.1] hours versus 8.5 [5.8 to 12] hours; P = 0.008) and the hypoglycemic events were significantly less (P = 0.042) in the study group in comparison with the control group. There was no difference in the potassium abnormalities and rate of decline of glucose. A survey on a scale of 1 to 10 found the majority of physicians and nurses rated the protocol as safe (83%) and effective (96%). Fifty-four percent of the nurses, however, found the protocol difficult to follow.


CONCLUSIONS
Our study showed that implementation of an algorithm-based protocol reduced the DKA resolution time and hypoglycemic events without compromising electrolyte imbalance, and was associated with improved clinical measures of DKA management.
Department of Internal Medicine, Marshall University, Joan C. Edwards School of Medicine, 1249 15th Street, Huntington, West Virginia 25701. maghrabi@marshall.edu
Adam H
AH
Maghrabi
Eyad
E
Hamoudeh
Tamer
T
Hassan
Todd
T
Gress
Abid
A
Yaqub
Tipu F
TF
Saleem
D000328:Adult; D000465:Algorithms; D016022:Case-Control Studies; D002985:Clinical Protocols; D016883:Diabetic Ketoacidosis / Q000628:therapy*; D019468:Disease Management; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome