Management of Diabetic Keto-Acidosis in Critically ill Patients

Management of DKA in critically ill patients requires rapid recognition, hemodynamic stabilization, and correction of metabolic derangements. Initial treatment includes aggressive fluid resuscitation with isotonic saline to restore perfusion, followed by insulin infusion to suppress ketogenesis and...

• Diabetic ketoacidosis (DKA) is defined by hyperglycemia, ketosis (blood or urine), and metabolic acidosis. It must be differentiated from hyperglycemic hyperosmolar state (HHS), which involves hyperglycemia and hyperosmolarity but lacks significant ketosis or acidosis. DKA severity is stratified as mild, moderate, or severe based on glucose levels, ketonemia, and acidosis (pH or bicarbonate). Not all criteria must be fulfilled to define a DKA as mild moderate or severe.