Skip to main content
SpringerLink
Log in

Management of diabetic ketoacidosis

  • Understanding the Disease
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN (2009) Hyperglycemic crises in adult patients with diabetes. Diabetes Care 32:1335–1343

    Article  CAS  Google Scholar 

  2. Dhatariya KK, Societies JBD, for Inpatient C (2022) The management of diabetic ketoacidosis in adults—an updated guideline from the Joint British Diabetes Society for Inpatient Care. Diabet Med 39:e14788

    Article  Google Scholar 

  3. Kamel KS, Halperin ML (2015) Acid-base problems in diabetic ketoacidosis. N Engl J Med 372:546–554

    Article  Google Scholar 

  4. Handelsman Y, Henry RR, Bloomgarden ZT, Dagogo-Jack S, DeFronzo RA, Einhorn D, Ferrannini E, Fonseca VA, Garber AJ, Grunberger G, LeRoith D, Umpierrez GE, Weir MR (2016) American association of clinical endocrinologists and American College of endocrinology position statement on the association of sglt-2 inhibitors and diabetic ketoacidosis. Endocr Pract 22:753–762

    Article  Google Scholar 

  5. Kuppermann N, Ghetti S, Schunk JE, Stoner MJ, Rewers A, McManemy JK, Myers SR, Nigrovic LE, Garro A, Brown KM, Quayle KS, Trainor JL, Tzimenatos L, Bennett JE, DePiero AD, Kwok MY, Perry CS, Olsen CS, Casper TC, Dean JM, Glaser NS, Group PDFS (2018) Clinical trial of fluid infusion rates for pediatric diabetic ketoacidosis. N Engl J Med 378:2275–2287

    Article  CAS  Google Scholar 

  6. Besen B, Boer W, Honore PM (2021) Fluid management in diabetic ketoacidosis: new tricks for old dogs? Intensive Care Med 47:1312–1314

    Article  Google Scholar 

  7. Ramanan M, Attokaran A, Murray L, Bhadange N, Stewart D, Rajendran G, Pusapati R, Petty M, Garrett P, Kruger P, Peake S, Billot L, Venkatesh B (2021) Sodium chloride or Plasmalyte-148 evaluation in severe diabetic ketoacidosis (SCOPE-DKA): a cluster, crossover, randomized, controlled trial. Intensive Care Med 47:1248–1257

    CAS  Google Scholar 

  8. Self WH, Evans CS, Jenkins CA, Brown RM, Casey JD, Collins SP, Coston TD, Felbinger M, Flemmons LN, Hellervik SM, Lindsell CJ, Liu D, McCoin NS, Niswender KD, Slovis CM, Stollings JL, Wang L, Rice TW, Semler MW (2020) Clinical effects of balanced crystalloids vs saline in adults with diabetic ketoacidosis: a subgroup analysis of cluster randomized clinical trials. JAMA Netw Open 3:e2024596

    Article  Google Scholar 

  9. Chua HR, Schneider A, Bellomo R (2011) Bicarbonate in diabetic ketoacidosis—a systematic review. Ann Intensive Care 1:23

    Article  Google Scholar 

  10. Hillier TA, Abbott RD, Barrett EJ (1999) Hyponatremia: evaluating the correction factor for hyperglycemia. Am J Med 106:399–403

    Article  CAS  Google Scholar 

  11. Umpierrez GE, Latif K, Stoever J, Cuervo R, Park L, Freire AX (2004) Efficacy of subcutaneous insulin lispro versus continuous intravenous regular insulin for the treatment of patients with diabetic ketoacidosis. Am J Med 117:291–296

    Article  CAS  Google Scholar 

  12. Naunheim R, Jang TJ, Banet G, Richmond A, McGill J (2006) Point-of-care test identifies diabetic ketoacidosis at triage. Acad Emerg Med 13:683–685

    Article  Google Scholar 

  13. Yu HY, Agus M, Kellogg MD (2011) Clinical utility of abbott precision xceed Pro(R) ketone meter in diabetic patients. Pediatr Diabetes 12:649–655

    Article  CAS  Google Scholar 

  14. Lopes AD, Maciel AT, Park M (2011) Evolutive physicochemical characterization of diabetic ketoacidosis in adult patients admitted to the intensive care unit. J Crit Care 26:303–310

    Article  CAS  Google Scholar 

  15. Nagaoka D, Nassar Junior AP, Maciel AT, Taniguchi LU, Noritomi DT, Azevedo LC, Neto LM, Park M (2010) The use of sodium-chloride difference and chloride-sodium ratio as strong ion difference surrogates in the evaluation of metabolic acidosis in critically ill patients. J Crit Care 25:525–531

    Article  CAS  Google Scholar 

Download references

Acknowledgements

None.

Funding

None.

Author information

Authors and Affiliations

  1. Medical ICU, Internal Medicine Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Rua Dr. Enéas de Carvalho Aguiar, 255, Room 11083, 11Th Floor, São Paulo, SP, 05403-000, Brazil

    Bruno A. M. P. Besen

  2. Intensive Care Unit, A.C. Camargo Cancer Center, São Paulo, SP, Brazil

    Bruno A. M. P. Besen

  3. Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE), São Paulo, SP, Brazil

    Bruno A. M. P. Besen

  4. Pulmonary Division, Heart Institute (InCor), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil

    Otavio T. Ranzani

  5. Barcelona Institute for Global Health, ISGlobal, Barcelona, Spain

    Otavio T. Ranzani

  6. Bloomsbury Institute of Intensive Care Medicine, University College London, London, UK

    Mervyn Singer

Authors
  1. Bruno A. M. P. Besen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Otavio T. Ranzani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mervyn Singer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bruno A. M. P. Besen.

Ethics declarations

Conflicts of interest

The authors report no conflicts of interest related to the contents of this manuscript.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 39 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Besen, B.A.M.P., Ranzani, O.T. & Singer, M. Management of diabetic ketoacidosis. Intensive Care Med 49, 95–98 (2023). https://doi.org/10.1007/s00134-022-06894-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00134-022-06894-9

Search

Navigation