Diabetic ketoacidosis is an emergency medical condition that can be life-th
reatening if not treated properly. The incidence of this condition may be i
ncreasing, and a 1 to 2 percent mortality rate has stubbornly persisted sin
ce 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-insul
in-dependent diabetes mellitus), particularly obese black patients, is not
as rare as was once thought. The management of patients with diabetic ketoa
cidosis includes obtaining a thorough but rapid history and performing a ph
ysical examination in an attempt to identify possible precipitating factors
. The major treatment of this condition is initial rehydration (using isoto
nic saline) with subsequent potassium replacement and low-dose insulin ther
apy The use of bicarbonate is not recommended in most patients. Cerebral ed
ema, one of the most dire complications of diabetic ketoacidosis, occurs mo
re commonly in children and adolescents than in adults. Continuous follow-u
p of patients using treatment algorithms and flow sheets can help to minimi
ze adverse outcomes. Preventive measures include patient education and inst
ructions for the patient to contact the physician early during an illness.