Joint British Diabetes Societies guideline for the management of diabetic ketoacidosis

• DOI: 10.1111/j.1464-5491.2011.03246.x
• Publication Date: 2011-01-22T07:07:23Z
• Authors: M. W. Savage; K. K. Dhatariya; A. Kilvert; G. Rayman; J. A. E. Rees; C. H. Courtney; L. Hilton; P. H. Dyer; M. S. Hamersley
• Keywords: Diabetic ketoacidosis; Ketoacidosis; Ketosis; Guideline

Diabet. Med. 28, 508–515 (2011) Abstract The Joint British Diabetes Societies guidelines for the management of diabetic ketoacidosis (these do not cover Hyperosmolar Hyperglycaemic Syndrome) are available in full at: http://www.diabetes.org.uk/About_us/Our_Views/Care_recommendations/The‐Management‐of‐Diabetic‐Ketoacidosis‐in‐Adults ; http://www.diabetes.nhs.uk/publications_and_resources/reports_and_guidance http://www.diabetologists‐abcd.org.uk/JBDS_DKA_Management.pdf . This article summarizes main changes from previous and discusses rationale new recommendations. key points are: Monitoring response to treatment method choice monitoring is bedside measurement capillary blood ketones using a ketone meter. If available, venous pH bicarbonate should be used conjunction with glucose assess response. Venous rather than arterial (unless respiratory problems dictate otherwise) gas analysers. Intermittent laboratory confirmation pH, electrolytes only. Insulin administration infused intravenously at weight‐based fixed rate until ketosis has resolved. When falls below 14 mmol/l, 10% added allow fixed‐rate insulin continued. already taking, long‐acting analogues such as glargine (Lantus ® , Sanofi Aventis, Guildford, Surry, UK) or detemir (Levemir Novo Nordisk, Crawley, West Sussex, UK.) continued usual doses. Delivery care diabetes specialist team involved soon possible. Patients nursed areas where staff experienced ketoacidosis.