title: [Treatment of diabetic ketoacidosis using 2009 American Diabetes Association guidelines].
abstract: BACKGROUND
  During 2009, new guidelines for the treatment of diabetic ketoacidosis were published by the American Diabetes Association.
  
  
  OBJECTIVE
  To assess the impact of new treatment guidelines on the evolution of patients treated for diabetic ketoacidosis (KAD).
  
  
  METHODS
  Anonymous data was obtained from computational medical records of patients treated for KAD at our institution two years before ("Traditional Protocol") and TWO years after ("ADA-2009 Protocol") the publication of the 2009 American Diabetes Association (ADA) KAD guidelines.
  
  
  RESULTS
  Twenty three patients aged 36.5 ± 15.1 years were treated with the traditional method and 23 patients aged 44.4 ± 21.1 years were treated following 2009 ADA guidelines. Among patients treated with the traditional protocol and treated following ADA 2009 guidelines, the diabetes type 1/type 2 ratio was 18/5 and 19/16 respectively (p = NS), the glycosylated hemoglobin on admission was 12.6 ± 2.5 and 14.3 ± 2.7% respectively (p = 0.03), minimal blood pH was 7.15 ± 0.14 and 7.19 ± 0.09 respectively (p = NS), bicarbonate was required in seven and no patient respectively (p = 0.01), hypokalemia < 3.5 mEq/L occurred in 78.2 and 48.5% of patients (p = 0.03), the lapse until resolution was 28.7 ± 28.0 and 28.8 ± 20.6 hours (p = NS). Only one patient, treated following ADA 2009 guidelines, died.
  
  
  CONCLUSIONS
  Introduction of the ADA-2009 protocol for the treatment of KAD resulted in decrease in the use of intravenous bicarbonate and a reduction in the incidence of hypokalemia. There was no impact neither in the lapse until resolution or lethality.
authors.forename: Pablo
authors.initials: P
authors.lastname: Olmos
authors.forename: Aníbal
authors.initials: A
authors.lastname: Donoso
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Arab
authors.forename: Ian
authors.initials: I
authors.lastname: Niklitschek
authors.forename: Nicolás
authors.initials: N
authors.lastname: Mertens
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Arce
authors.forename: Rosario
authors.initials: R
authors.lastname: Lemus
authors.forename: Valentina
authors.initials: V
authors.lastname: Serrano
authors.forename: Bruno
authors.initials: B
authors.lastname: Grassi
authors.forename: Kristel
authors.initials: K
authors.lastname: Strodthoff
authors.forename: Eduardo
authors.initials: E
authors.lastname: Abbott
authors.forename: Andrés
authors.initials: A
authors.lastname: Aizman
authors.forename: María Verónica
authors.initials: MV
authors.lastname: González
mesh_terms: D000328:Adult; D002985:Clinical Protocols; D016883:Diabetic Ketoacidosis / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D017410:Practice Guidelines as Topic; D012955:Societies, Medical
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin