Diabetic ketoacidosis - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Diabetic ketoacidosis (DKA) is characterized by a biochemical triad of hyperglycemia, ketonemia, and acidemia, with rapid symptom onset.
Common symptoms and signs include polyuria, polydipsia, polyphagia, weakness, weight loss, tachycardia, dry mucous membranes, poor skin turgor, hypotension, and, in severe cases, shock.
Successful treatment includes correction of volume depletion, hyperglycemia, electrolyte imbalances, and comorbid precipitating events, with frequent monitoring.
Complications of treatment include hypoglycemia, hypokalemia, hypoxemia, and rarely pulmonary edema.
Cerebral edema, a rare but potentially rapidly fatal complication, occurs mainly in children. It may be prevented by avoiding overly rapid fluid and electrolyte replacement.

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History & Exam
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Triad of DKA
Pathogenesis of DKA and HHS; triggers include stress, infection, and insufficient insulin. FFA: free fatty acid; HHS: hyperosmolar hyperglycemic state
Management of adult DKA. Abbreviations: blood glucose (BG); diabetic ketoacidosis (DKA); hour (h); intravenous (IV); subcutaneous (SC)
Algorithm for the management of potassium and bicarbonate

Citations

Key Articles

Kitabchi AE, Umpierrez GE, Miles JM, et al. Hyperglycemic crises in adult patients with diabetes: a consensus statement from the American Diabetes Association. Diabetes Care. 2009 Jul;32(7):1335-43.[Abstract][Full Text]
American Diabetes Association. Standards of care in diabetes - 2024. Diabetes Care. 2024 Jan 1;47(Suppl 1):S1-321.[Full Text]
Umpierrez G, Korytkowski M. Diabetic emergencies - ketoacidosis, hyperglycaemic hyperosmolar state and hypoglycaemia. Nat Rev Endocrinol. 2016 Apr;12(4):222-32.[Abstract]

Referenced Articles

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