Diabetic ketoacidosis primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Primary Prevention

Primary prevention of diabetic ketoacidosis (DKA) includes the following measures:

• Recognition of early signs:
  • Vomiting
  • Hyperglycemia
  • Large ketonuria
  • Weakness
  • Heavy breathing or shortness of breath
• Early recognition of inciting event of DKA:
  • Missed insulin dose or error in dosing
  • Intercurrent illness, especially infection
  • Psychologic stress
  • Surgery or trauma
• Early intervention:
  • Enhanced and more frequent monitoring of blood glucose and urine ketones
  • Increased fluid intake
  • Seek advice from health care team
• Aggressive intervention in patients with recurrent episodes of DKA:
  • Psychiatric evaluation
  • Individual and family evaluation/intervention usually required
  • Continuous subcutaneous insulin infusion helpful in some patients
  • Possible out-of-home placement