Published online Dec 15, 2018. doi: 10.4239/wjd.v9.i12.226
Peer-review started: August 7, 2018
First decision: October 5, 2018
Revised: October 16, 2018
Accepted: November 15, 2018
Article in press: November 16, 2018
Published online: December 15, 2018
Diabetic ketoacidosis (DKA) is a complication seen in patients with both type 1 and type 2 diabetes. Due to its large, growing economic impact with associated morbidity, closer look at proper management is important. Factors involved in appropriate management involves fluid resuscitation, insulin regimen, and electrolyte replacement including types of fluid and insulin treatment. The caveat with generalized protocol is application to special populations such as renal or heart failure patients the sequelae of complications due to pathophysiology of the disease processes. This leads to complications and longer length of stay in the hospital, therefore, possibly increased cost and resource utilization during the hospitalization. This review takes a closer look at current guidelines of DKA management and resource utilization, the drawbacks of current management protocols and the cost associated with it. Therefore, a need for amendment to existing protocol or initiation of a newer guideline that properly manages DKA should incorporate special populations and appropriate regimen of fluid resuscitation, insulin therapy and electrolyte management.
Core tip: Diabetic ketoacidosis (DKA) management in both type 1 and type 2 has been in practice for many years, yet the complications and cost associated with it is ever increasing. Treatment with proper resource utilization is the key to appropriate management of DKA, decreased complications and length of stay, therefore, decreased cost of treatment. This review aims to review previous guidelines, choice of therapy, cost associated with it and need for amendments to existing protocols to increase efficacy of DKA treatment, decrease complications and decrease economic burden due to mismanagement of DKA.