Diabetic Ketoacidosis (DKA): A Severe Diabetes Mellitus Disorder

Abstract

Diabetic ketoacidosis (DKA) is a life-threatening medical emergency that requires immediate evaluation and treatment. It remains a significant complication of diabetes and is increasing alarmingly worldwide. It is an endocrine complication that involves hyperglycemia, anion gap metabolic acidosis, and ketosis. It is characterized by hyperglycaemia with glucose is greater than 11 mmol/l (200 mg/dl), capillary/venous pH is less than 7.3, bicarbonate (HCO₃–) is less than 15 mEq/l, serum anion gap is greater than 16 mmol/l, moderate to severe dehydration is seen and creatinine ratio is increased, and ketones (ketonemia and ketonuria ≥3 mmol/l) are present. It occurs in patients with type 1 diabetes (T1D), and type 2 diabetes (T2D); and early diagnosis, monitoring, and treatment are necessary for the welfare of the patients. Treatment of DKA involves volume expansion, insulin replacement, and prevention of hypokalemia. DKA can be prevented through the earlier recognition and initiation of insulin therapy. An attempt has been taken here to discuss the aspects of DKA in some detail.