Diabetic Ketoacidosis (cont.)
- Fluid replacement and insulin administration intravenously (IV) are the primary and most critical initial treatments
for diabetic ketoacidosis. These therapies together reverse dehydration,
lower blood acid levels, and restore normal sugar and electrolyte balance.
Fluids must be administered wisely - not at an excessive rate or total volume
due to the risk of brain swelling (cerebral edema). Potassium is typically added
to IV fluids to correct total body depletion of this important electrolyte.
- Insulin must not be delayed and must be given promptly as a continuous
infusion (not as a bolus - a large dose given rapidly) to stop further ketone
formation and to stabilize tissue function by driving available potassium back
inside the body's cells. Once blood glucose levels have fallen below 300mg/dL,
glucose may be co-administered with ongoing insulin administration to avoid the
development of hypoglycemia (low blood sugar).
- People diagnosed with diabetic ketoacidosis are usually admitted into the hospital for treatment and may be admitted to the intensive care unit.
- Some people with mild acidosis
with modest fluid and electrolyte losses, and who can reliably drink fluid and
follow medical instructions can be safely treated and sent home. Follow-up must
be available with a health care practitioner. Individuals with diabetes who are
vomiting should be admitted to the hospital or urgent care center for further
observation and treatment.
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