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Rationale:
- Patients with diabetes mellitus require insulin even during periods of starvation, due to elevated levels of counter-regulatory
hormones such as glucagon, cortisol, growth hormone, and catecholamines the produce hyperglycemia.
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Evidence:
- Several prospective studies including analysis of surveys have confirmed that insulin cessation and poor adherence to treatment
were common causes of diabetic ketoacidosis (2; 3; 4; 5; 6; 7).
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Comments:
- Insulin cessation may also be accidental, especially in the case of continuous subcutaneous insulin infusion pumps. Patients
must be made aware of the potential problems associated with interruption of insulin delivery. Patients commonly discontinue
insulin therapy for economic reasons, lack of knowledge of their disease, and weight control.
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Ebenezer A. Nyenwe, MD, editorial consultant, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Heather Lochnan, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Deborah Korenstein, MD, FACP, Co-Editor, PIER, has no financial relationships with pharmaceutical companies, biomedical device
manufacturers, or health-care related organizations. Richard B. Lynn, MD, FACP, Co-Editor, PIER, has no financial relationships
with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
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for clinical judgment and does not represent an official position of
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or PDFs may rapidly become obsolete. Therefore, PIER users should
compare the date of the last update on the website with any printout
to ensure that the information being referred to is the most current
available.
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PIER is copyrighted © 2012 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.
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Diabetic Ketoacidosis
> Prevention
