National survey of the management of Diabetic Ketoacidosis (DKA) in the UK in 2014

• DOI: 10.1111/dme.12875
• Publication Date: 2015-08-19T05:18:49Z
• Authors: K. K. Dhatariya; I. Nunney; K. Higgins; M. J. Sampson; G. Iceton
• Keywords: Diabetic ketoacidosis

To examine, in a national survey, the outcomes of adult patients presenting with DKA 2014, mapped against accepted UK guidance.Data were collected standardized form covering clinical and biochemical outcomes, risk discharge planning. The was sent to all diabetes specialist teams (n = 220). Anonymized data on five consecutive admitted between 1 May 2014 30 November 2014.A total 283 forms received 281 patients) from 72 hospitals, which 71.4% used guidelines. results showed that 7.8% cases occurred existing inpatients, 6.1% admissions newly diagnosed 33.7% had at least one episode preceding year. median times starting 0.9% sodium chloride intravenous insulin 41.5 60 min, respectively. time resolution 18.7 h length hospital stay 2.6 days. Significant adverse occurred, 27.6% developing hypoglycaemia 55% reported as having hypokalaemia. There also significant issues care processes. Initial nurse-led observations carried out well, but subsequent patient monitoring remained suboptimal. Most not seen by member team during first 6 h, 95% before discharge. A minority letters primary did contain necessary information.Despite widespread adoption guidance, several areas management are suboptimal, being associated avoidable risk.