Diabetic Ketoacidosis

  • Hira Bakhtiar
  • Robyn ScatenaEmail author


Diabetic ketoacidosis (DKA) is characterized by hyperglycemia, metabolic acidosis, ketone production, and severe volume depletion. There is considerable variability in the presentation of DKA, ranging from euglycemia and acidosis to severe hyperglycemia. Initial evaluation should include identification of precipitating factors. Treatment of DKA requires correction of hyperglycemia with intravenous insulin infusions, frequent monitoring and replacement of electrolytes, correction of hypovolemia with intravenous fluids, and possible correction of acidosis. Electrolyte levels must be monitored carefully during treatment as life-threatening hypokalemia or hypophosphatemia may develop. Sodium bicarbonate is reserved for the initial treatment of extreme acidemia. Milder cases of DKA may be safely treated outside of the ICU setting with subcutaneous insulin.


DKA Diabetic ketoacidosis Euglycemic DKA Diabetes Insulin Fluid resuscitation Potassium Bicarbonate Cerebral edema 


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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Internal Medicine, Pulmonary and Critical SectionNorwalk HospitalNorwalkUSA

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