Management of diabetic ketoacidosis

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.