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Metabolism. 2016 Apr;65(4):507-21. doi: 10.1016/j.metabol.2015.12.007. Epub 2015 Dec 19.

The evolution of diabetic ketoacidosis: An update of its etiology, pathogenesis and management.

Author information

1
Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, 920 Madison Ave., Suite 300A, Memphis, TN 38163. Electronic address: enyenwe@uthsc.edu.
2
Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, 920 Madison Ave., Suite 300A, Memphis, TN 38163.

Abstract

The prognosis of diabetic ketoacidosis has undergone incredibly remarkable evolution since the discovery of insulin nearly a century ago. The incidence and economic burden of diabetic ketoacidosis have continued to rise but its mortality has decreased to less than 1% in good centers. Improved outcome is attributable to a better understanding of the pathophysiology of the disease and widespread application of treatment guidelines. In this review, we present the changes that have occurred over the years, highlighting the evidence behind the recommendations that have improved outcome. We begin with a discussion of the precipitants and pathogenesis of DKA as a prelude to understanding the rationale for the recommendations. A brief review of ketosis-prone type 2 diabetes, an update relating to the diagnosis of DKA and a future perspective are also provided.

KEYWORDS:

Diabetic ketoacidosis; Etiology; Management; Pathogenesis

PMID:
26975543
DOI:
10.1016/j.metabol.2015.12.007
[Indexed for MEDLINE]

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