title: The International Society of Pediatric and Adolescent Diabetes guidelines for management of diabetic ketoacidosis: Do the guidelines need to be modified?
abstract: The current version of the International Society of Pediatric and Adolescent Diabetes (ISPAD) guidelines for management of diabetic ketoacidosis (DKA) is largely based on the Lawson Wilkins Pediatric Endocrine Society/European Society of Pediatric Endocrinology (LWPES/ESPE) consensus statement on DKA in children and adolescents published in 2004. This article critically reviews and presents the most pertinent new data published in the past decade, which have implications for diagnosis and management. Four elements of the guidelines warrant modification: (i) The definition of DKA; (ii) insulin therapy; (iii) water and salt replacement; and (iv) blood ß-hydroxybutyrate measurements for the management of DKA.
authors.affiliation: Diabetes Program, Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
authors.forename: Joseph I
authors.initials: JI
authors.lastname: Wolfsdorf
mesh_terms: D020155:3-Hydroxybutyric Acid / Q000097:blood; D000293:Adolescent; D001929:Brain Edema / Q000150:complications / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D016903:Drug Monitoring; D019317:Evidence-Based Medicine; D005440:Fluid Therapy; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D007390:International Agencies; D019095:Point-of-Care Systems; D017410:Practice Guidelines as Topic; D012958:Societies, Scientific
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D020155:3-Hydroxybutyric Acid
keywords: diabetes; diabetic ketoacidosis; management guidelines