Diabetic Ketoacidosis in adults: Part 3. Special situations

Abstract

Prompt diagnosis and treatment of Diabetic Ketoacidosis (DKA) with the correct administration of intravenous (i.v.) fluids, fixed rate insulin infusion (FRII) and guideline-based K+ replacement are essential for optimum outcomes. However, treatment guidelines may need to be adapted in special situations such as pregnancy, end stage renal disease or where resources, such as infusion pump equipment, may not be available. Children require treatment according to specific paediatric guidelines particularly to minimise the risk of cerebral oedema. Although DKA is a serious and complex medical emergency, skilled medical care can reduce mortality rates to below 1%.