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Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. [1] Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion and occasionally loss of consciousness. [1] A person's breath may develop a specific "fruity" or acetone smell. [1]
[3] [4] The guidelines have been widely used across the UK and helped reduce variations by standardising approach to inpatient diabetes care. [1] Hypoglycaemia [5] Diabetic Ketoacidosis (DKA) in Adults [6] Hyperosmolar hyperglycemia state (HHS) in adults with diabetes [7] Glycaemic control in people with cancer [8] Diabetes at the front door [9]
The most common cause of ketoacidosis is a deficiency of insulin in type 1 diabetes or late-stage type 2 diabetes. This is called diabetic ketoacidosis and is characterized by hyperglycemia, dehydration and metabolic acidosis. Other electrolyte disturbances such as hyperkalemia and hyponatremia may also be present.
The management of KPD revolves around 3 main components: acutely managing DKA, identification of KPD subtype, and longterm diabetic management similar to that in type 2 diabetes. [6] As patients are likely to initially present in DKA, the acute management of DKA is the first priority.
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]
The major differential diagnosis is diabetic ketoacidosis (DKA). In contrast to DKA, serum glucose levels in HHS are extremely high, usually greater than 40-50 mmol/L (600 mg/dL). [6] Metabolic acidosis is absent or mild. [6] A temporary state of confusion (delirium) is also more common in HHS than DKA. HHS also tends to affect older people more.
The most common causes of high anion gap metabolic acidosis are: ketoacidosis, lactic acidosis, kidney failure, and toxic ingestions. [3]Ketoacidosis can occur as a complication of diabetes mellitus (diabetic ketoacidosis), but can occur due to other disorders, such as chronic alcoholism and malnutrition.
The main goal of diabetes management is to keep blood glucose (BG) levels as normal as possible. [1] If diabetes is not well controlled, further challenges to health may occur. [1] People with diabetes can measure blood sugar by various methods, such as with a BG meter or a continuous glucose monitor, which monitors over several days. [2]
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