Diabetic Ketoacidosis

The defining features of diabetic ketoacidosis (DKA) are metabolic acidosis, ketonemia, and hyperglycemia. The most common precipitating factors of DKA are acute medical illness (infection), nonadherence to insulin therapy, new onset diabetes, and medications that interfere with carbohydrate metabolism. The diagnostic criteria for DKA include acidosis, low serum bicarbonate, increased anion gap, ketonemia, and ketonuria. Treatment of DKA includes intravenous fluid resuscitation, correction of hyperglycemia and ketoacidosis with insulin, management of electrolyte abnormalities, and the treatment of any precipitating causes of DKA. Implementation of standardized protocols to treat DKA can improve outcomes and potentially reduce hospital length of stay. © 2014 Elsevier Inc..