Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is an acute metabolic disorder that occurs in those with Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus (T2DM) which presents with persistent hyperglycemia (≥250 mg/ dL) leading to a high anion gap metabolic acidosis with ketosis in the setting of either a relative or absolute insulin deficiency. Evaluation for the precipitating cause of DKA, such as trauma, infection, pump malfunction or medication noncompliance is essential. While DKA can be life-threatening, and hospitalizations for DKA are on the rise, adverse outcomes are minimal if promptly treated with aggressive fluid resuscitation, adequate insulin therapy and close monitoring of electrolytes. Prevention of future episodes of DKA is reliant upon adequate patient and caregiver education with a focus on treatment strategies in acute illness or with travel. The aim of this article is to provide a comprehensive overview of the epidemiology, clinical presentation, pathophysiology, treatment and prevention of DKA.