Diabetic ketoacidosis

In addition to hypoglycemia and hyperglycemic nonketotic syndrome (HNKS) in type 2 diabetes, diabetic ketoacidosis (DKA) represents an important complication of type 1 diabetes in particular-despite improvements in treatment. This work focusses on current recommendations for diagnosis and treatment of diabetic ketoacidosis, and describes current research projects. To this aim, a structured summary of the current literature (review articles, guideline recommendations) is presented. DKA requires fast, outcome oriented-treatment in order to prevent disease progression. Compensation of the fluid deficit is thus of primary initial importance. Thereafter, the electrolyte deficit is compensated, insulin is substituted and metabolic acidosis is treated; comorbidities, causes and complications are also treated. There are a manageable number of recommendations for the treatment of DKA. Further research is needed to determine the optimal initial resuscitation fluid and insulin dosage needed to reduce DKA-associated morbidity and mortality.