Recognising and treating diabetic ketoacidosis

Diabetes is characterised by hyperglycemia, which results from issues with insulin secretion and/or action (Higginson et al, 2019). Chronic complications of diabetes include an accelerated development of cardiovascular disease, end-stage renal disease, loss of visual acuity, and limb amputations (Higginson et al, 2019). However, acutely, diabetes can also result in emergency complications such as diabetic ketoacidosis (DKA).

DKA was traditionally observed in patients with type 1 diabetes and is still more common in this group. DKA is the leading cause of death among young to middle-aged adults and children living with type 1 diabetes (Gibb et al, 2016). However, it is also seen in patients with type 2 diabetes, particularly in those who are taking insulin, or following the release of catabolic hormones during stress such as in cases of trauma, surgery, infection or other acute illness (Beba and Mills, 2024).