CLINICAL MANAGEMENT GUIDELINE

Diabetic ketoacidosis without coma

ICD10: Type 2 diabetes mellitus with ketoacidosis without coma [E11.10]

Treatment: primary management for ketoacidosis

Diagnostic criteria for DKA 1- Serum glucose > 250 mg/dl 2- Ketonemia/ketonuria (urine ketones ≥3+) 3- PH <7.3 or serum bicarbonate < 18 meq/L 4- Anion Gap >12


Success criteria: 1- Restoration of volume depletion. 2- Anion gap closure. 3- Glucose < 200 mg/dl. 4- K+ is within the upper normal range.

Treatments

Level 1 / 1
pharmacological
Sodium Chloride
ROUTE
IV
DOSE
1000.000 mL/hour
FREQUENCY
Infusion over 1 hr
pharmacological
Potassium Chloride
ROUTE
IV
DOSE
30.000 mEq
FREQUENCY
OD
pharmacological
Regular Insulin, Human
ROUTE
IV
DOSE
0.100 Unit/Hour
FREQUENCY
Q1Hr
pharmacological
Sodium Bicarbonate
ROUTE
IV
DOSE
100.000 mmol
FREQUENCY
STAT
pharmacological
Glucose
ROUTE
IV
DOSE
10.000 %
FREQUENCY
STAT
consultation
Referral to endocrinology service
consultation
Diabetic care education

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