Diabetic ketoacidosis: A Common Complication of Diabetes Mellitus-Diagnosis, Treatment, and Interventions-An Updated Review Article

Abstract

Background: Diabetic ketoacidosis (DKA) is a severe and potentially fatal complication of diabetes mellitus (DM), arising from insulin deficiency and characterized by hyperglycemia, hyperketonemia, and metabolic acidosis. Despite advancements in diabetes care, DKA remains a leading cause of hospitalization and mortality among diabetic patients.
Aim: This review aims to consolidate recent findings on the epidemiology, pathophysiology, diagnosis, treatment, and challenges in managing DKA to optimize clinical outcomes. Also, focus on the contribution role of pharmacists, clinical pathologists, and nursing in management and controlling of the DKA.
Methods: A systematic literature search was conducted using PubMed, targeting articles published between 2012 and 2023 in peer-reviewed journals. Boolean operators integrated terms such as "epidemiology," "pathophysiology," "diagnosis," and "therapy for diabetic ketoacidosis." Six relevant articles were selected for detailed analysis.
Results: DKA accounts for approximately 14% of hospital admissions and 16% of diabetes-related deaths. It is more prevalent in type 1 diabetes but also occurs in type 2 cases. Pathophysiologically, insulin deficiency, increased counter-regulatory hormones, and oxidative stress contribute to ketosis and acidosis. Diagnosis relies on clinical presentation and laboratory findings such as elevated plasma glucose, arterial pH, serum ketones, and anion gap. Management involves correcting fluid and electrolyte imbalances, initiating insulin therapy, and addressing precipitating factors like infections. Advances in monitoring and therapeutic strategies have improved outcomes, though challenges such as hypoglycemia, fluid overload, and euglycemic DKA persist.
Conclusion: DKA is a critical metabolic emergency requiring prompt, multidisciplinary intervention. Despite progress in treatment protocols, patient outcomes can be improved by addressing adherence barriers, refining diagnostic methods, and mitigating treatment complications. Future research should prioritize strategies for early detection and targeted interventions.