Cited by 461Diabetes Management and ResearchHyperglycemia and glycemic control in critically ill and hospitalized patientsDiabetes Treatment and Management

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Diabetic ketoacidosis

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Dhatariya, Ketan K., Glaser, Nicole S., Codner, Ethel, Umpierrez, Guillermo E.·2020·Nature Reviews Disease Primers

Abstract

Diabetic ketoacidosis (DKA) is the most common acute hyperglycaemic emergency in people with diabetes mellitus. A diagnosis of DKA is confirmed when all of the three criteria are present - 'D', either elevated blood glucose levels or a family history of diabetes mellitus; 'K', the presence of high urinary or blood ketoacids; and 'A', a high anion gap metabolic acidosis. Early diagnosis and management are paramount to improve patient outcomes. The mainstays of treatment include restoration of circulating volume, insulin therapy, electrolyte replacement and treatment of any underlying precipitating event. Without optimal treatment, DKA remains a condition with appreciable, although largely preventable, morbidity and mortality. In this Primer, we discuss the epidemiology, pathogenesis, risk factors and diagnosis of DKA and provide practical recommendations for the management of DKA in adults and children.

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Metadata

Authors
Dhatariya, K. K., Glaser, N. S., Codner, E., & Umpierrez, G. E.
Affiliations
  • University of East Anglia (GB)
  • University of California, Davis (US)
  • Emory University (US)
Corresponding author
Umpierrez, Guillermo E.
Venue
Nature Reviews Disease Primers
Published
2020-05-14
Volume
6
Issue
1
Pages
40-40
ISSN
2056-676X (ISSN-L)
OpenAlex
W4211168619
Cited by
461
References
262
Citations by year
2026: 80 · 2025: 104 · 2024: 92 · 2023: 71 · 2022: 63 · 2021: 44 · 2020: 6
FWCI
7.10
Type
journal article
Language
en
Open access
Locations
  • Nature Reviews Disease Primers (publishedVersion)
  • PubMed (publishedVersion)
  • UEA Digital Repository (University of East Anglia) (submittedVersion)
  • Universidad de Chile (submittedVersion, cc-by-nc-nd)
Funders
  • American Diabetes Association (1-17-IBS-186)
  • Sanofi
  • Emory University
  • Dexcom
  • Novo Nordisk
  • Fondo Nacional de Ciencia y Tecnología
  • National Institutes of Health (P30DK11102, UL1TR002378)
  • National Institute of Diabetes and Digestive and Kidney Diseases (P30DK11102, P30DK111024)
  • National Center for Advancing Translational Sciences
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
diabetic ketoacidosis, diabetes mellitus, anion gap metabolic acidosis, ketone bodies, insulin therapy, fluid resuscitation, electrolyte replacement, pathogenesis, risk factors, diagnosis, recurrence prevention, children
MeSH terms
Acidosis, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Fluid Therapy, Humans, Hypoglycemic Agents, Insulin, Risk Factors, Diabetic Ketoacidosis, Disease Management

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