Diabetic Ketoacidosis Author: Heather Lochnan, MD
Approved for review - 2009-03-25
Author information and module status
Prevention
Screening
Diagnosis
Consultation for Diagnosis
Hospitalization
Non-drug Therapy
Drug Therapy
Patient Education
Consultation for Management
Follow-up
Tables
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References
Glossary
What's New
Patient Information
Additional Resources
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References
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3. 2Morris AD, Boyle DI, McMahon AD, Greene SA, MacDonald TM, Newton RW. Adherence to insulin treatment, glycaemic control, and ketoacidosis in insulin-dependent diabetes mellitus. The DARTS/MEMO Collaboration. Diabetes Audit and Research in Tayside Scotland. Medicines Monitoring Unit. Lancet. 1997;350:1505-10. (PMID: 9388398)
4. 2Musey VC, Lee JK, Crawford R, Klatka MA, McAdams D, Phillips LS. Diabetes in urban African-Americans. I. Cessation of insulin therapy is the major precipitating cause of diabetic ketoacidosis. Diabetes Care. 1995;18:483-9. (PMID: 7497857)
5. 2Polonsky WH, Anderson BJ, Lohrer PA, Aponte JE, Jacobson AM, Cole CF. Insulin omission in women with IDDM. Diabetes Care. 1994;17:1178-85. (PMID: 7821139)
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7. 2Umpierrez GE, Kelly JP, Navarrete JE, Casals MM, Kitabchi AE. Hyperglycemic crises in urban blacks. Arch Intern Med. 1997;157:669-75. (PMID: 9080921)
8. 2Vanelli M, Chiari G, Ghizzoni L, Costi G, Giacalone T, Chiarelli F. Effectiveness of a prevention program for diabetic ketoacidosis in children. An 8-year study in schools and private practices. Diabetes Care. 1999;22:7-9. (PMID: 10333896)
9. 2Glaser NS, Kuppermann N, Yee CK, Schwartz DL, Styne DM. Variation in the management of pediatric diabetic ketoacidosis by specialty training. Arch Pediatr Adolesc Med. 1997;151:1125-32. (PMID: 9369874)
10. 3Delaney MF, Zisman A, Kettyle WM. Diabetic ketoacidosis and hyperglycemic hyperosmolar nonketotic syndrome. Endocrinol Metab Clin North Am. 2000;29:683-705, V. (PMID: 11149157)
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16. 3Wilson DR, D'Souza L, Sarkar N, Newton M, Hammond C. New-onset diabetes and ketoacidosis with atypical antipsychotics. Schizophr Res. 2003;59:1-6. (PMID: 12413635)
17. 3Ananth J, Venkatesh R, Burgoyne K, Gunatilake S. Atypical antipsychotic drug use and diabetes. Psychother Psychosom. 2002;71:244-54. (PMID: 12207104)
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21. 3Fleckman AM. Diabetic ketoacidosis. Endocrinol Metab Clin North Am. 1993;22:181-207. (PMID: 8325282)
22. 2Levetan CS, Passaro MD, Jablonski KA, Ratner RE. Effect of physician specialty on outcomes in diabetic ketoacidosis. Diabetes Care. 1999;22:1790-5. (PMID: 10546009)
23. 1Wiggam MI, O'Kane MJ, Harper R, Atkinson AB, Hadden DR, Trimble ER, et al. Treatment of diabetic ketoacidosis using normalization of blood 3-hydroxybutyrate concentration as the endpoint of emergency management. A randomized controlled study. Diabetes Care. 1997;20:1347-52. (PMID: 9283776)
24. 2Wagner A, Risse A, Brill HL, Wienhausen-Wilke V, Rottmann M, Sondern K, et al. Therapy of severe diabetic ketoacidosis. Zero-mortality under very-low-dose insulin application. Diabetes Care. 1999;22:674-7. (PMID: 10332664)
25. 2Kitabchi AE, Murphy MB, Spencer J, Matteri R, Karas J. Is a priming dose of insulin necessary in a low-dose insulin protocol for the treatment of diabetic ketoacidosis? Diabetes Care. 2008;31:2081-5. (PMID: 18694978)
26. 2Umpierrez GE, Latif K, Stoever J, Cuervo R, Park L, Freire AX, et al. Efficacy of subcutaneous insulin lispro versus continuous intravenous regular insulin for the treatment of patients with diabetic ketoacidosis. Am J Med. 2004;117:291-6. (PMID: 15336577)
27. 2Della Manna T, Steinmetz L, Campos PR, Farhat SC, Schvartsman C, Kuperman H, et al. Subcutaneous use of a fast-acting insulin analog: an alternative treatment for pediatric patients with diabetic ketoacidosis. Diabetes Care. 2005;28:1856-61. (PMID: 16043723)
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29. 2Viallon A, Zeni F, Lafond P, Venet C, Tardy B, Page Y, et al. Does bicarbonate therapy improve the management of severe diabetic ketoacidosis? Crit Care Med. 1999;27:2690-3. (PMID: 10628611)
30. 2Okuda Y, Adrogue HJ, Field JB, Nohara H, Yamashita K. Counterproductive effects of sodium bicarbonate in diabetic ketoacidosis. J Clin Endocrinol Metab. 1996;81:314-20. (PMID: 8550770)
31. 2Green SM, Rothrock SG, Ho JD, Gallant RD, Borger R, Thomas TL, et al. Failure of adjunctive bicarbonate to improve outcome in severe pediatric diabetic ketoacidosis. Ann Emerg Med. 1998;31:41-8. (PMID: 9437340)
32. 2Glaser N, Barnett P, McCaslin I, Nelson D, Trainor J, Louie J, et al. Risk factors for cerebral edema in children with diabetic ketoacidosis. The Pediatric Emergency Medicine Collaborative Research Committee of the American Academy of Pediatrics. N Engl J Med. 2001;344:264-9. (PMID: 11172153)
33. 3Guneysel O, Guralp I, Onur O. Bicarbonate therapy in diabetic ketoacidosis. Bratisl Lek Listy. 2008;109(10):453-4. (PMID: 19166130)
34. 2Nyenwe EA, Loganathan RS, Blum S, Ezuteh DO, Erani DM, Wan JY, et al. Active use of cocaine: an independent risk factor for recurrent diabetic ketoacidosis in a city hospital. Endocr Pract. 2007;13:22-9. (PMID: 17360297)
35. 3Kitabchi AE, Nyenwe EA. Hyperglycemic crises in diabetes mellitus: diabetic ketoacidosis and hyperglycemic hyperosmolar state. Endocrinol Metab Clin North Am. 2006;35:725-51, viii. (PMID: 17127143)
FAQs
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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