From the Guidelines
Diabetic ketoacidosis (DKA) is defined as a metabolic state characterized by high blood sugar levels, the buildup of ketones in the blood, and metabolic acidosis, typically requiring a blood glucose level greater than 250 mg per dL, pH of 7.3 or less, serum bicarbonate level less than 18 mEq per L, and moderate ketonemia, as stated in the study published in 2010 1.
Key Characteristics of DKA
- High blood sugar levels
- Buildup of ketones in the blood
- Metabolic acidosis
- Blood glucose level greater than 250 mg per dL
- pH of 7.3 or less
- Serum bicarbonate level less than 18 mEq per L
- Moderate ketonemia
Recent Guidelines
The most recent study published in 2023 1 reiterates the importance of individualizing treatment based on careful clinical and laboratory assessment, with management goals including restoration of circulatory volume and tissue perfusion, resolution of hyperglycemia, and correction of electrolyte imbalance and acidosis.
Diagnosis and Treatment
DKA requires immediate medical attention and is treated with insulin administration, fluid replacement, and electrolyte correction to restore normal metabolic function and prevent complications such as cerebral edema, cardiac arrhythmias, or kidney failure, as supported by the study published in 2021 1.
Key Considerations
- Individualization of treatment based on careful clinical and laboratory assessment
- Management goals include restoration of circulatory volume and tissue perfusion, resolution of hyperglycemia, and correction of electrolyte imbalance and acidosis
- Treatment with insulin administration, fluid replacement, and electrolyte correction
- Prevention of complications such as cerebral edema, cardiac arrhythmias, or kidney failure
From the Research
Definition of Diabetic Ketoacidosis (DKA)
- Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 and type 2 diabetes resulting from an absolute or relative insulin deficiency 2.
- DKA is characterized by the triad of hyperglycemia, metabolic acidosis, and ketosis, although hyperglycemia has been de-emphasized in recent guidelines due to the increasing incidence of euglycemic DKA 2.
- A diagnosis of DKA is confirmed when all of the three criteria are present: 'D', either elevated blood glucose levels or a family history of diabetes mellitus; 'K', the presence of high urinary or blood ketoacids; and 'A', a high anion gap metabolic acidosis 3.
- DKA can be defined as a condition with hyperglycemia (blood sugar >250 mg/dl), metabolic acidosis (arterial pH <7.3 and serum bicarbonate <18 mEq/L), and ketosis, although euglycemic DKA can occur with blood glucose levels of less than 200 mg/dl 4.