A life-threatening medical emergency in diabetics secondary to insulin deficiency and characterized by hyperglycemia, ketosis, metabolic acidosis, electrolyte disturbances, and marke...
Recent illness, injury, or surgery
Changes in diet or medications
Missed insulin doses/ noncompliance
Insulin pump failure
Weight loss in patients recently diagnosed with type 1 DM
Oxygen and airway management, as needed
Establish IV access.
Start isotonic crystalloid solution (e.g., 0.9% saline, or lactated ringers bolus).
All, but mild ...
Monitor mental status, vital signs, and urine output q30–60min until improved, then q2–4h.
Monitor blood sugar q1h until <200 mg/dL, then q2–6...
American Diabetes Association. Standards of medical care in diabetes—2013. Diabetes Care. 2013;36(Suppl 1):S11–S66. [View Abstract on OvidMedline]
Sheikh-Ali M, Karon BS, Basu...
Diabetes Mellitus, Type 1
Algorithm: Diabetic Ketoacidosis (DKA), Treatment
E10.10 Type 1 diabetes mellitus with ketoacidosis without coma
E13.10 Oth diabetes mellitus with ketoacidosis without coma
E10.11 Type 1 diabetes mellitus with ketoacidosis with coma
Admit if blood glucose >250 mg/dL, pH <7.3, HCO3 ≤15 mEq/L, and ketones in urine.
Potassium is falsely elevated due to acidosis; start replacement when K+ ≤5.2 mg/dL and urine out...
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