Clinical Case Database / Category: Patient Management

The management of diabetic ketoacidosis

Publication details

Dr Ian Seetho BA, BMedSci, BMBS, MRCP, Prof Kevin Hardy MA, MD, FRCP
Foundation Years Journal, volume 8, issue 5, p.34 (123Doc Education, London, May 2014)


Diabetic Ketoacidosis (DKA) is a potentially life threatening condition characterised by hyperglycaemia, ketonaemia and metabolic acidosis, as a result of relative or absolute insulin deficiency. As the prevalence of diabetes continues to rise, it is important to be able to understand why each treatment is given and to be able to manage patients who present with this condition effectively. In this article, we discuss the pathophysiological aspects of DKA, followed by an overview of aspects of management from presentation leading to recovery.

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Dr Ian Seetho BA, BMedSci, BMBS, MRCP

Department of Obesity & Endocrinology,
University of Liverpool,
Department of Diabetes & Endocrinology,
St Helens & Knowsley Teaching Hospitals NHS Trust,
St Helens Hospital, Marshalls Cross Road,St Helens,
WA9 3DA.

Prof Kevin Hardy MA, MD, FRCP

Department of Diabetes & Endocrinology,
St Helens & Knowsley Teaching Hospitals NHS Trust,
St Helens Hospital, Marshalls Cross Road,
St Helens, WA9 3DA.


1. Steenkamp DW, Alexanian SM, McDonnell ME. Adult Hyperglycemic Crisis: A Review and Perspective. Curr. Diabetes Rep. Feb 2013;13(1):130-137.
2. Nyenwe EA, Kitabchi AE. Evidence-based management of hyperglycemic emergencies in diabetes mellitus. Diabetes Res. Clin. Pract. Dec 2011;94(3):340-351.
3. Van Ness-Otunnu R, Hack JB. HYPERGLYCEMIC CRISIS. J. Emerg. Med. Nov 2013;45(5):797-805.
4. Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic Crises in Adult Patients with Diabetes. Diabetes Care. Jul 2009;32(7):1335-1343.
5. Barski L, Nevzorov R, Harman-Boehm I, et al. Comparison of Diabetic Ketoacidosis in Patients With Type-1 and Type-2 Diabetes Mellitus. Am. J. Med. Sci. Apr 2013;345(4):326-330. 6. Gale EAM, Tattersall RB. Hypothermia - Complication of Diabetic Ketoacidosis. Br. Med. J.1978;2(6149):1387-1389.
7. Nambu T, Mori K, Shinoto Y, et al. Diabetic ketoacidosis accompanied by hypothermia: A case report. Diabetes Res. Clin. Pract. Jun 2012;96(3):326-330.
8. Munro JF, Campbell IW, McCuish AC, Duncan LJP. Euglycemic Diabetic Ketoacidosis. Br. Med. J. 1973;2(5866):578-580.
9. Nyirenda MJ, Tang JI, Padfield PL, Seckl JR. Hyperkalaemia. Br. Med. J. Oct 2009;339.
10. The Management of Diabetic Ketoacidosis in Adults- Second Edition. In: Group JBDSIC, ed2013.
11. Trachtenbarg DE. Diabetic ketoacidosis. Am. Fam. Physician. May 2005;71(9):1705-1714.
12. Hardern RD, Quinn ND. Emergency management of diabetic ketoacidosis in adults. Emerg. Med. J. May 2003;20(3):210-213.


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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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