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Treatments and drugs
By Mayo Clinic staffIf you're diagnosed with diabetic ketoacidosis, you may be treated in the emergency room or admitted to the hospital. Treatment usually involves a three-pronged approach:
- Fluid replacement. You'll receive fluids — either orally or through a vein (intravenously) — until you're rehydrated. The fluids will replace those you've lost through excessive urination, as well as help dilute the excess sugar in your blood.
- Electrolyte replacement. Electrolytes are minerals in your blood that carry an electric charge, such as sodium, potassium and chloride. The absence of insulin can lower the level of several electrolytes in your blood. You'll receive electrolytes through your veins to help keep your heart, muscles and nerve cells functioning normally.
- Insulin therapy. Insulin reverses the processes that cause diabetic ketoacidosis. Along with fluids and electrolytes, you'll receive insulin therapy — usually through a vein. When your blood sugar level falls below 240 mg/dL (13.3 mmol/L) and your blood is no longer acidic, you may be able to stop intravenous insulin therapy and resume your normal subcutaneous insulin therapy.
As your body chemistry returns to normal, your doctor will consider what may have triggered the episode of diabetic ketoacidosis. Depending on the circumstances, you may need additional treatment. For example, if you have previously undiagnosed diabetes, your doctor will help you create a diabetes treatment plan. If your doctor suspects a bacterial infection, he or she may prescribe antibiotics. If a heart attack seems possible, your doctor may recommend further evaluation of your heart.
- Ketoacidosis (DKA). American Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/ketoacidosis-dka.html. Accessed July 3, 2012.
- Ferri FF. Ferri's Clinical Advisor 2013: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-323-08373-7..C2010-0-68318-0&isbn=978-0-323-08373-7&uniqId=343834918-3#4-u1.0-B978-0-323-08373-7..C2010-0-68318-0--TOP. Accessed July 3, 2012.
- Kitabchi A, et al. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009;32:1335.
- Siafarikas A, et al. Type 1 diabetes in children: Emergency management. Australian Family Physician. 2010;39:290.
- Usher-Smith JA, et al. Factors associated with the presence of diabetic ketoacidosis at diagnosis of diabetes in children and young adults: A systematic review. British Medical Journal. 2011;343:d4092.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/content.aspx?aID=9141196. Accessed July 3, 2012.
- McPhee SJ, et al. Current Medical Diagnosis & Treatment 2012. 51st ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/content.aspx?aID=15524. Accessed July 3, 2012.
- Checking for ketones. American Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/checking-for-ketones.html. Accessed July 3, 2012.
- Castro MR (expert opinion). Mayo Clinic, Rochester, Minn. July 6, 2012.
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