Adults diabetic ketoacidosis

Šarūnas Masys1, Dominyka Kaušaitė 2

1Republican Siauliai Hospital, Siauliai, Lithuania

2Faculty of Medicine, Vilnius University, Vilnius, Lithuania


Background. Diabetic ketoacidosis (DKA) is one of the most common complications of hyperglycemia with the highest risk of death in diabetic patients. This disease is characterized by hyperglycemia, metabolic acidosis and ketosis. Early diagnosis and treatment are key determinants of patient survival. In these patients, inpatient treatment in intensive care units is appropriate because of the need for aggressive intravenous fluids, electrolyte correction, insulin therapy in combination with the diagnosis and treatment of the cause of the disease, and frequent monitoring of the patient’s general condition and laboratory tests.

Aim: to review the literature on the epidemiology, diagnosis and treatment recommendations for adult diabetic ketoacidosis.

Methodology. A literature review was performed based on PubMed and Google Scholar scientific databases, selecting publications from 2015 to 2021 in English, using keywords in the original language: “diabetes mellitus”, “diabetic ketoacidosis”, “insulin therapy”.

Results: DKA often results from increased insulin requirements, non-adherence to insulin therapy, or newly diagnosed diabetes mellitus (DM). Although the number of deaths due to DKA has decreased significantly in the general population, it remains high in developing countries. Patients with DKA are characterized by polydipsia, polyuria, general weakness, disorders of consciousness. Changes observed in laboratory tests characteristic of DKA are hyperglycemia, metabolic acidosis, ketosis. Treatment of DKA: restoration of fluid deficiency (usually with 0.9% NaCl solution), restoration of electrolytes, especially sodium (Na), chlorine (Cl) and potassium (K), and insulin therapy.

Conclusions: Effective treatment for DKA includes infusion therapy, electrolyte restoration, insulin therapy, and treatment of the cause of diabetic ketoacidosis. It is important to be able to recognize the first symptoms of DKA and to prevent this, diabetic patients should be taught about diabetes and the importance of insulin release in its treatment.

Keywords: diabetes; diabetic ketoacidosis; insulin therapy.