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Clinical Overview
Definition
Diagnosis and Treatment

Diabetic Ketoacidosis

Diagnosis and Treatment

DKA is usually diagnosed using a combination of medical history, physical examination, and laboratory tests.

Blood tests are used to determine blood sugar, potassium, sodium, and other electrolyte levels; tests for ketone levels, kidney function, and blood acidity can also be helpful in reaching diagnosis. In some cases, chest x-rays, ECGs, urine tests, and CT scans may also be called for.

The main treatment for DKA is intravenous fluid replacement to reverse dehydration and dilute glucose and acidity in the blood. Potassium is often added to replace lost electrolytes. Once hydration is achieved, insulin is given to bring blood sugar back to a safe level. When blood sugar has fallen to within an acceptable range, a combination of insulin and glucose is commonly administered so that insulin can do its work without causing dangerously low blood sugar levels.

A DKA diagnosis usually requires hospital admission and may call for intensive care unit admission, depending on the severity of the condition. Mild acidosis and dehydration may be resolved with outpatient emergency treatment, but it is important that patients follow up after even a mild episode of DKA, in order to rule out any preventable underlying causes and ensure that the condition does not return.

Most people with DKA recover completely with appropriate, prompt treatment. About two percent of cases lead to death. Occasionally, underlying illnesses cause additional symptoms, and treatment complications may include low blood sugar, low potassium, fluid in the lungs (pulmonary edema), or brain swelling (cerebral edema).

Home care for DKA is centered around prevention of high blood sugar through careful monitoring, insulin treatment, maintaining hydration, and knowing the warning signs for underlying causes (such as infection).

Last updated: Dec-17-07

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