Saudi Journal of Medicine and Medical Sciences

REVIEW ARTICLE
Year
: 2020  |  Volume : 8  |  Issue : 3  |  Page : 165--173

Management of diabetic ketoacidosis in adults: A narrative review


Mohsen S Eledrisi, Abdel-Naser Elzouki 
 Department of Medicine, Hamad Medical Corporation; Department of Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar

Correspondence Address:
Prof. Abdel-Naser Elzouki
Department of Medicine, Hamad Medical Corporation, P.O. Box: 3050, Doha
Qatar

Diabetic ketoacidosis (DKA) is the most common hyperglycemic emergency and causes the greatest risk for death in patients with diabetes mellitus. DKA more commonly occurs among those with type 1 diabetes, yet almost a third of the cases occur among those with type 2 diabetes. Although mortality rates from DKA have declined to low levels in general, it continues to be high in many developing countries. DKA is characterized by hyperglycemia, metabolic acidosis and ketosis. Proper management of DKA requires hospitalization for aggressive intravenous fluids, insulin therapy, electrolyte replacement as well as identification and treatment of the underlying precipitating event along with frequent monitoring of patient's clinical and laboratory states. The most common precipitating causes for DKA include infections, new diagnosis of diabetes and nonadherence to insulin therapy. Clinicians should be aware of the occurrence of DKA in patients prescribed sodium-glucose co-transporter 2 inhibitors. Discharge plans should include appropriate choice and dosing of insulin regimens and interventions to prevent recurrence of DKA. Future episodes of DKA can be reduced through patient education programs focusing on adherence to insulin and self-care guidelines during illness and improved access to medical providers. New approaches such as extended availability of phone services, use of telemedicine and utilization of public campaigns can provide further support for the prevention of DKA.


How to cite this article:
Eledrisi MS, Elzouki AN. Management of diabetic ketoacidosis in adults: A narrative review.Saudi J Med Med Sci 2020;8:165-173


How to cite this URL:
Eledrisi MS, Elzouki AN. Management of diabetic ketoacidosis in adults: A narrative review. Saudi J Med Med Sci [serial online] 2020 [cited 2020 Sep 22 ];8:165-173
Available from: http://www.sjmms.net/article.asp?issn=1658-631X;year=2020;volume=8;issue=3;spage=165;epage=173;aulast=Eledrisi;type=0