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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 is usually 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 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 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 March 31, 2010.
- Ferri FF. Diabetic ketoacidosis. In: Ferri FF. Ferri's Clinical Advisor 2010. St. Louis, Mo.: Mosby; 2009. http://www.mdconsult.com/das/book/body/192147260-3/0/2088/189.html#4-u1.0-B978-0-323-05609-0..00013-7--sc0070_3802. Accessed March 31, 2010.
- Eisenbarth GS, et al. Type 1 diabetes mellitus. In: Kronenberg HM, et al. Kronenberg: Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/192147260-3/0/1555/195.html?tocnode=54108733&fromURL=195.html#4-u1.0-B978-1-4160-2911-3..50033-9--cesec72_2996. Accessed March 31, 2010.
- Fogel N, et al. Management of diabetic ketoacidosis in the emergency department. Clinical Pediatric Emergency Medicine. 2009;10:246.
- Checking for ketones. American Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/checking-for-ketones.html. Accessed March 31, 2010.
- If you have diabetes, know your blood sugar numbers! National Diabetes Education Program. http://www.ndep.nih.gov/media/KnowNumbers_Eng.pdf. Accessed March 31, 2010.
- Kitabchi A, et al. Clinical features and diagnosis of diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults. http://www.uptodate.com/home/index.html. Accessed March 31, 2010.
- Collazo-Clavell, ML (expert opinion). Mayo Clinic, Rochester, Minn. April 20, 2010.
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