Diabetes Research and Clinical Practice
Volume 77, Issue 1 , Pages 113-119 , July 2007

Treatment of diabetic ketoacidosis in adults in Denmark: A national survey

  • Otto M. Henriksen

      Affiliations

    • Endocrine Section, Department of Internal Medicine I, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark
    • Department of Clinical Physiology and Nuclear Medicine, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark
    • Corresponding Author InformationCorresponding author at: Department of Clinical Physiology and Nuclear Medicine, University Hospital Glostrup, Ndr. Ringvej, DK-2600 Glostrup, Denmark. Tel.: +45 4323 2433; fax: +45 4323 3928.
  • ,
  • Julie B. Prahl

      Affiliations

    • Paediatric Department, University Hospital Gentofte, Niels Andersen Vej 65, 2900 Hellerup, Denmark
  • ,
  • Michael E. Røder

      Affiliations

    • Endocrine Section, Department of Internal Medicine I, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark
  • ,
  • Ole Lander Svendsen

      Affiliations

    • Endocrine Section, Department of Internal Medicine I, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark

Received 31 March 2006 ,Accepted 13 October 2006.

References 

  1. Tattersall RB. A paper which changed clinical practice (slowly). Jacob Holler on potassium deficiency in diabetic acidosis (1946). Diabet. Med. 1999;16:978–984
  2. Henriksen OM, Roder ME, Prahl JB, Svendsen OL. Diabetic ketoacidosis in Denmark Incidence and mortality estimated from public health registries. Diabetes Res. Clin. Pract. 2006;
  3. Kitabchi AE, Umpierrez GE, Murphy MB, Barrett EJ, Kreisberg RA, Malone JI, et al. Management of hyperglycemic crises in patients with diabetes. Diabetes Care. 2001;24:131–153
  4. Kitabchi AE, Umpierrez GE, Murphy MB, Barrett EJ, Kreisberg RA, Malone JI, et al. Hyperglycemic crises in diabetes. Diabetes Care. 2004;27(Suppl. 1):S94–S102
  5. Edge JA, Dunger DB. Variations in the management of diabetic ketoacidosis in children. Diabet. Med. 1994;11:984–986
  6. Haas RM, Hoffman AR. Treatment of diabetic ketoacidosis: should mode of insulin administration dictate use of intensive care facilities?. Am. J. Med. 2004;117:357–358
  7. Umpierrez GE, Latif K, Stoever J, Cuervo R, Park L, Freire AX, et al. Efficacy of subcutaneous insulin lispro versus continuous intravenous regular insulin for the treatment of patients with diabetic ketoacidosis. Am. J. Med. 2004;117:291–296
  8. May ME, Young C, King J. Resource utilization in treatment of diabetic ketoacidosis in adults. Am. J. Med. Sci. 1993;306:287–294
  9. Kitabchi AE, Ayyagari V, Guerra SM. The efficacy of low-dose versus conventional therapy of insulin for treatment of diabetic ketoacidosis. Ann. Intern. Med. 1976;84:633–638
  10. Wagner A, Risse A, Brill HL, Wienhausen-Wilke V, Rottmann M, Sondern K, et al. Therapy of severe diabetic ketoacidosis. Zero-mortality under very-low-dose insulin application. Diabetes Care. 1999;22:674–677
  11. Sacks HS, Shahshahani M, Kitabchi AE, Fisher JN, Young RT. Similar responsiveness of diabetic ketoacidosis to low-dose insulin by intramuscular injection and albumin-free infusion. Ann. Intern. Med. 1979;90:36–42
  12. Fisher JN, Shahshahani MN, Kitabchi AE. Diabetic ketoacidosis: low-dose insulin therapy by various routes. N. Engl. J. Med. 1977;297:238–241
  13. Ersoz HO, Ukinc K, Kose M, Erem C, Gunduz A, Hacihasanoglu AB, et al. Subcutaneous lispro and intravenous regular insulin treatments are equally effective and safe for the treatment of mild and moderate diabetic ketoacidosis in adult patients. Int. J. Clin. Pract. 2006;60:429–433
  14. Della MT, Steinmetz L, Campos PR, Farhat SC, Schvartsman C, Kuperman H, et al. Subcutaneous use of a fast-acting insulin analog: an alternative treatment for pediatric patients with diabetic ketoacidosis. Diabetes Care. 2005;28:1856–1861
  15. Umpierrez GE, Cuervo R, Karabell A, Latif K, Freire AX, Kitabchi AE. Treatment of diabetic ketoacidosis with subcutaneous insulin aspart. Diabetes Care. 2004;27:1873–1878
  16. Wiggam MI, O’Kane MJ, Harper R, Atkinson AB, Hadden DR, Trimble ER, et al. Treatment of diabetic ketoacidosis using normalization of blood 3-hydroxybutyrate concentration as the endpoint of emergency management. A randomized controlled study. Diabetes Care. 1997;20:1347–1352
  17. Lorber DL. Sliding scale insulin. Diabetes Care. 2001;24:2011–2012
  18. Adrogue HJ, Barrero J, Eknoyan G. Salutary effects of modest fluid replacement in the treatment of adults with diabetic ketoacidosis. Use in patients without extreme volume deficit. JAMA. 1989;262:2108–2113
  19. Hillman K. Fluid resuscitation in diabetic emergencies—a reappraisal. Intensive Care Med. 1987;13:4–8
  20. Harris GD, Fiordalisi I, Harris WL, Mosovich LL, Finberg L. Minimizing the risk of brain herniation during treatment of diabetic ketoacidemia: a retrospective and prospective study. J. Pediatr. 1990;117:22–31
  21. Edge JA. Cerebral oedema during treatment of diabetic ketoacidosis: are we any nearer finding a cause?. Diabetes Metab. Res. Rev. 2000;16:316–324
  22. Brown TB. Cerebral oedema in childhood diabetic ketoacidosis: is treatment a factor?. Emerg. Med. J. 2004;21:141–144
  23. Morris LR, Murphy MB, Kitabchi AE. Bicarbonate therapy in severe diabetic ketoacidosis. Ann. Intern. Med. 1986;105:836–840
  24. Gamba G, Oseguera J, Castrejon M, Gomez-Perez FJ. Bicarbonate therapy in severe diabetic ketoacidosis. A double blind, randomized, placebo controlled trial. Rev. Invest. Clin. 1991;43:234–238
  25. Viallon A, Zeni F, Lafond P, Venet C, Tardy B, Page Y, et al. Does bicarbonate therapy improve the management of severe diabetic ketoacidosis?. Crit. Care Med. 1999;27:2690–2693
  26. Laffel L. Ketone bodies: a review of physiology, pathophysiology and application of monitoring to diabetes. Diabetes Metab. Res. Rev. 1999;15:412–426
  27. Wallace TM, Matthews DR. Recent advances in the monitoring and management of diabetic ketoacidosis. QJM. 2004;97:773–780
  28. Brandenburg MA, Dire DJ. Comparison of arterial and venous blood gas values in the initial emergency department evaluation of patients with diabetic ketoacidosis. Ann. Emerg. Med. 1998;31:459–465
  29. Kreshak A, Chen EH. Arterial blood gas analysis: are its values needed for the management of diabetic ketoacidosis?. Ann. Emerg. Med. 2005;45:550–551
  30. Basu A, Close CF, Jenkins D, Krentz AJ, Nattrass M, Wright AD. Persisting mortality in diabetic ketoacidosis. Diabet. Med. 1993;10:282–284
  31. Hamblin PS, Topliss DJ, Chosich N, Lording DW, Stockigt JR. Deaths associated with diabetic ketoacidosis and hyperosmolar coma 1973–1988. Med. J. Aust. 1989;151:439–444
  32. Singh RK, Perros P, Frier BM. Hospital management of diabetic ketoacidosis: are clinical guidelines implemented effectively?. Diabet. Med. 1997;14:482–486
  33. Felner EI, White PC. Improving management of diabetic ketoacidosis in children. Pediatrics. 2001;108:735–740
  34. Ilag LL, Kronick S, Ernst RD, Grondin L, Alaniz C, Liu L, et al. Impact of a critical pathway on inpatient management of diabetic ketoacidosis. Diabetes Res. Clin. Pract. 2003;62:23–32

PII: S0168-8227(06)00484-0

doi: 10.1016/j.diabres.2006.10.013

Diabetes Research and Clinical Practice
Volume 77, Issue 1 , Pages 113-119 , July 2007