Key Changes in DKA Guidelines: Modern vs. Historical Approaches
I cannot provide a comprehensive comparison of new versus old DKA guidelines because the evidence provided does not contain specific DKA management guidelines from either historical or contemporary sources that would allow for a meaningful comparison.
What the Evidence Actually Contains
The provided evidence primarily addresses:
Chronic Kidney Disease (CKD) guidelines from KDOQI spanning 2003-2012, focusing on anemia management, diabetes with CKD, and general CKD staging 1
General diabetes management in CKD patients, including glycemic control targets (HbA1c of 7.0%), lipid management, and albuminuria treatment 1, 2
Research studies on DKA management from 2003-2024 that discuss implementation of protocols and general management principles, but do not represent formal guideline comparisons 3, 4, 5, 6, 7
Limited DKA-Relevant Information Available
From the research evidence, some contemporary DKA management principles include:
Euglycemic DKA recognition: Recent guidelines have de-emphasized hyperglycemia as an absolute requirement for DKA diagnosis due to increasing incidence of euglycemic DKA, particularly with SGLT2 inhibitor use 6
Protocol implementation: Standardized DKA protocols improve outcomes, with evidence showing reduced time to anion gap closure and decreased length of stay when protocols are followed 3
Insulin administration: IV infusion of regular human insulin is preferred, with initial IV bolus before low-dose insulin infusions 4
Critical Gap
To answer your question properly, I would need access to actual DKA-specific clinical practice guidelines (such as those from the American Diabetes Association, Joint British Diabetes Societies, or Endocrine Society) comparing historical versions to current versions, which are not present in the provided evidence.