Management of diabetic ketoacidosis

Abstract

DKA is a medical emergency with a significant morbidity and mortality. It is now recommended that FRIVII be used with bedside measurement of metabolic parameters. The DST should always be involved as soon as possible and ideally within 24 hours because this has been demonstrated to be associated with a better patient experience and reduced length of stay. In the management of diabetic ketoacidosis the following guidance should therefore be followed: • measure blood ketones, venous (not arterial) pH and bicarbonate and use results as treatment markers • monitor ketones and glucose using bedside meters, when available and operating within their quality assurance range • monitor electrolytes on blood gas analysers with intermittent laboratory confirmation • replace 'sliding scale' insulin with weight-based FRIVII • involve the DST as soon as possible • continue long-acting insulin analogues as normal.1 © Royal College of Physicians, 2011. All rights reserved.