Diabetic Ketoacidosis - A Review And Update


  • Mr. Manu Jose
  • Mr. Sundararaman Sheshadri
  • Ms. Rajalakshmi Mathialagan
  • Mr. Dilip Krishnan
  • Mr. Arun Ramachandran
  • Mr. Babin Dhas Reejo


Diabetic ketoacidosis (DKA), insulin therapy, ketone concentration, cerebral edema, counter regulatory hormones, glycogenolysis and gluconeogenesis


Diabetic ketoacidosis (DKA)is a life-threatening acute metabolic complication of diabetes mellitus caused by complete
lack of insulin in type 1diabetes mellitus or inadequate insulin levels associated with stress or severe illness either in type
1 or type 2 diabetes mellitus. The onset of diabetic ketoacidosis varies considerably (between 15% and 67%) from one
country to another. DKA is responsible for more than 500,000 hospital days per year at an estimated annual direct medical
expense and indirect cost of 2.4 billion USD. Severe depletion of water and electrolytes from intra- and extracellular fluid
compartments characterizes DKA. The key diagnostic feature in DKA is the elevation in circulating total blood ketone
concentration. Treatment includes fluid replacement, insulin therapy, potassium replacement, bicarbonate therapy and
phosphate therapy.As diabetes mellitus is increasing rapidly; more awareness is needed to care diabetic’s complications
such as DKA. Of diabetic complications, sudden deaths are mostly caused by DKA. In the past few decades standardized
care and studies decreased the mortality of DKA. The prevention of DKA will require further study as well as patient
education.The aim of this review is to find the cause, symptoms and treatment ofDKA, also to make aware of DKA.