Pharmacy to Dose: The Critical Care Podcast

Diabetic Ketoacidosis

May 2, 2023
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INSIGHT

Key Labs to Confirm DKA Diagnosis

  • Confirm DKA diagnosis with specific labs: pH < 7.3, serum bicarbonate < 18, positive serum/urine ketones, and elevated anion gap > 12.
  • Avoid jumping to treatment without verifying beta hydroxybutyrate and metabolic derangements first.
ADVICE

Start DKA Treatment with Fluids

  • Prioritize fluid resuscitation as the initial treatment in DKA with 15-20 mL/kg or 1-1.5 L in the first hour.
  • This restores organ perfusion before initiating insulin therapy.
INSIGHT

Balanced Fluids Benefit DKA Patients

  • Balanced fluids improve time to DKA resolution compared to normal saline by reducing chloride load.
  • Using balanced fluids is supported by multiple studies including a meta-analysis.
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