Diabetic Ketoacidosis

Goals and Objectives

Goals

  • Resident will be comfortable with initial evaluation and management of patients with diabetic ketoacidosis
  • Resident will be comfortable with special considerations in diagnosis and management of diabetic ketoacidosis in the pediatric population

Objectives

For patients presenting with diabetic ketoacidosis, resident will be able to:

  • Describe the pathophysiology of DKA
  • List criteria for diagnosing DKA
  • List common presenting signs and symptoms of patients in DKA
  • List diagnostic tests commonly indicated in the work-up of patients with DKA
    • Fingerstick glucose
    • CBC with differential
    • BMP / Mg / Phos
    • VBG
    • Serum ketones
    • UA
    • Infectious work-up (as indicated)
  • Name common electrolyte abnormalities and approach to treatment
    • Sodium
    • Potassium
      • Serum
      • Total-body
    • Magnesium
    • Phosphate
  • Name common acid-base abnormalities and approach to treatment
  • Name and describe three pillars of DKA management
    • Volume repletion
    • Insulin therapy / glucose management
    • Electrolyte management
  • Describe appropriate initial fluid resuscitation for
    • Pediatric patients
    • Adult patients
  • Describe appropriate insulin therapy:
    • Timing / conditions for initiation
    • Type / route / dose of insulin
  • Describe appropriate electrolyte repletion:
    • Thresholds for repletion
    • Route / dose of therapy
  • Name the tests used for continued monitoring and appropriate intervals for testing
    • Glucose
    • Electrolytes
    • pH
    • Anion Gap
  • Resident will be able to appropriately disposition patients diagnosed with DKA
Page Author: Eric Shappell
Page Created: June 12, 2015
Peer Reviewer: Mike Paddock
Peer Review Date: July 28, 2016
Last Modified: July 12, 2017