Abstract

Diabetic ketoacidosis (DKA) is an acute, well recognized and well studied complication of diabetes mellitus (DM). Its main characteristics are hyperglycemia, ketosis, acidosis and dehydration in case of profound insulin deficiency in diabetics. Earlier it was known to be a complication of patients with type I diabetes but now it occurs predominantly in type II diabetics. It is usually precipitated by infection of respiratory or urinary tract, insulin withdrawal due to decreased intake of food or taking a self implemented drug holiday and undiagnosed diabetes. One quarter of patients have no precipitating cause for DKA. Upon presentation, patient is severely dehydrated, hyperglycemic and has mild to moderate electrolyte imbalance. Goals set for the treatment are prioritize in order of hydration, euglycemia, correction of electrolyte imbalance and eradication of underlying cause. Preferred route of treatment is intravenous. Laboratory profiles are recommended to be monitored closely. With advancement of technologies, it is skillfully treated and complications are avoided well, yet incidence of DKA and mortality caused by DKA episode is increasing according to number. Also, the difference among the guidelines mentioned by experts is negligible. This leaves experts with no choice but to sit together and develop a consensus upon guidelines of diagnostic criteria, treatment goals and treatment protocol.