Pitfalls

If the blood sugar and ketones are not measured then the diagnosis of DKA will not be made; it is especially important in patients with the following symptoms:

  • Nausea
  • Vomiting
  • Abdominal pain
  • Altered mental state or GCS

If the potassium is below 3.5 mmol/L this needs to be corrected prior to starting insulin.

The acidosis of DKA is treated with fluid and insulin therapy.  The use of bicarbonate is not
indicated and may cause harm.

The underlying precipitating cause for DKA needs to be sought and treated.

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