Management of Diabetic Ketoacidosis in the Emergency Department

Diabetic ketoacidosis results from deficient insulin action and increased action of hormones such as catecholamines, glucagon, glucocorticoids, and growth hormone, which are produced during stress and which antagonize insulin's actions. Diabetic ketoacidosis is associated with a relatively high mortality rate. Treatment consists of appropriate fluid resuscitation, insulin infusion, adjustments of electrolytes and phosphate, and careful monitoring. The most common serious complication is cerebral edema.