Diabetic Ketoacidosis: Management and Complications - A Brief Review

Résumé fourni par la source

Diabetic Ketoacidosis (DKA) is a serious acute complication of diabetes mellitus characterized by hyperglycemia, metabolic acidosis and ketonemia. Although more frequent in patients with type 1 diabetes, it can also occur in individuals with type 2 diabetes under metabolic stress conditions. Main triggers include inadequate insulin use, infections and events that increase insulin demand or counterregulatory hormone production. Management requires a multidisciplinary approach, encompassing fluid replacement, electrolyte correction, insulin administration and treatment of the precipitating factor. Restoration of intravascular volume, inhibition of lipolysis and reversal of ketogenesis are fundamental for clinical stabilization. In this context, continuous monitoring of blood glucose and electrolytes particularly potassium is essential to avoid serious complications such as fatal hypokalemia. The most common iatrogenic complications are hypoglycemia and electrolyte disturbances (hypokalemia and hypophosphatemia), as well as cerebral edema, more prevalent in pediatric patients. Early identification and control of severity signs, together with effective management of the precipitating factor, are crucial to reduce DKA associated morbidity and mortality.

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