Management of diabetic ketoacidosis

Abbas E. Kitabchi, Barry Wall

Research output: Contribution to journalReview article

26 Citations (Scopus)

Abstract

Diabetic ketoacidosis is an emergency medical condition that can be life-threatening if not treated properly. The incidence of this condition may be increasing, and a 1 to 2 percent mortality rate has stubbornly persisted since the 1970s. Diabetic ketoacidosis occurs most often in patients with type 1 diabetes (formerly called insulin-dependent diabetes mellitus); however, its occurrence in patients with type 2 diabetes (formerly called non-insulin-dependent diabetes mellitus), particularly obese black patients, is not as rare as was once thought. The management of patients with diabetic ketoacidosis includes obtaining a thorough but rapid history and performing a physical examination in an attempt to identify possible precipitating factors. The major treatment of this condition is initial rehydration (using isotonic saline) with subsequent potassium replacement and low-dose insulin therapy. The use of bicarbonate is not recommended in most patients. Cerebral edema, one of the most dire complications of diabetic ketoacidosis, occurs more commonly in children and adolescents than in adults. Continuous follow- up of patients using treatment algorithms and flow sheets can help to minimize adverse outcomes. Preventive measures include patient education and instructions for the patient to contact the physician early during an illness.

Original languageEnglish (US)
Pages (from-to)455-464
Number of pages10
JournalAmerican Family Physician
Volume60
Issue number2
StatePublished - Aug 1 1999

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Diabetic Ketoacidosis
Patient Education
Type 1 Diabetes Mellitus
Type 2 Diabetes Mellitus
Precipitating Factors
Fluid Therapy
Brain Edema
Bicarbonates
Physical Examination
Potassium
Emergencies
Therapeutics
History
Insulin
Physicians
Mortality
Incidence

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Management of diabetic ketoacidosis. / Kitabchi, Abbas E.; Wall, Barry.

In: American Family Physician, Vol. 60, No. 2, 01.08.1999, p. 455-464.

Research output: Contribution to journalReview article

Kitabchi, AE & Wall, B 1999, 'Management of diabetic ketoacidosis', American Family Physician, vol. 60, no. 2, pp. 455-464.
Kitabchi, Abbas E. ; Wall, Barry. / Management of diabetic ketoacidosis. In: American Family Physician. 1999 ; Vol. 60, No. 2. pp. 455-464.
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