Endocrinology · Overview · 2 min read
Diabetic Ketoacidosis
DKA is hyperglycemia + ketosis + high anion-gap metabolic acidosis from insulin deficiency. Isotonic saline, insulin infusion, and electrolyte replacement reverse the syndrome within 24 hours in most patients.
Key points
- Diagnosis: glucose above 250 mg/dL, arterial pH below 7.30, bicarbonate below 18 mEq/L, ketonemia.
- Severity: mild pH 7.25-7.30; severe pH below 7.00 with stupor or coma.
- Resuscitation: isotonic saline 15 mL/kg over first hour; insulin 0.1 unit/kg/h once K+ above 3.3 mEq/L.
- Resolution: bicarbonate at least 18 mEq/L, pH at least 7.30, anion gap at most 12 mEq/L.
- Cerebral edema: 1% of pediatric DKA, mortality 25%; mannitol 1 g/kg is first-line therapy.
Exam relevance
USMLE Step 2USMLE Step 3MRCP
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