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Diabetic ketoacidosis (DKA) is a frequent and potentially life-threatening complication of type 1 diabetes. Though preventable and despite advances in monitoring technologies, insulin therapeutics and insulin delivery systems, the rates of both community and hospital acquired DKA remain largely unchanged. Although mortality today is relatively
6 sie 2021 · For severe acidosis (e.g., bicarbonate <5 mM), consider a 10 unit IV insulin bolus followed by an infusion at 0.2 U/kg/hr. Continue insulin infusion per protocol, until ALL the following criteria are met: Resolution of ketoacidosis (anion gap <10-12 mM, in the absence of renal failure). Bicarbonate >18 mM.
IV insulin infusion is recommended for critically ill patients with BG levels >180 mg/dL. The use of insulin infusion protocols standardizes care and improves clinical outcomes. Protocol should include strict BG monitoring and personalized insulin infusion rate titration to achieve and maintain BG targets.
Based on the other guidelines, and the indirect evidence from children, the JBDS-IP panel recommended that in adults with DKA the insulin infusion rate should be reduced to 0.05 units/kg/hour when blood glucose falls below 14 mmol/L. Joint British Diabetes Societies for Inpatient Care. The management of diabetic ketoacidosis in adults.
DIABETIC KETOACIDOSIS – INITIAL MANAGEMENT GUIDE. DIAGNOSIS OF DKA BLOOD GLUCOSE(BG) > 11*- (glucose may be normal in a known diabetic) + ACIDOSIS - pH <7.3 or HCO3-<15mmol/l + KETONAEMIA – Bld Ketones> 3mmol/l. *If Hyperglycaemic (>35mmol/L) in the absence of significant ketosis or acidosis – Consider Hyperosmolar Hyperglycaemic State ...
8 sie 2022 · While admission to an intensive care unit (ICU) remains the standard of care for severe diabetic ketoacidosis (DKA), the safety of managing mild-to-moderate DKA outside of the ICU is unclear. nonICU management of DKA could save considerable costs and prevent ICU overcrowding during times of crisis. [1]
27 kwi 2023 · Management of DKA requires reversing metabolic derangements by correcting volume depletion and electrolyte imbalances and administering insulin to correct acidosis while concurrently treating the precipitating illness [1].
