Most hospitals use standardized insulin and fluid protocols for managing patients with Diabetic Ketoacidosis (DKA). These protocols initiate a series of steps, including laboratory tests, fluid administration, insulin administration, and electrolyte correction. This study analysed information collected prospectively on a group of patients with diabetic ketoacidosis to review outcomes and management details. The study included 37 patients with a mean age of 38.1 ± 18.5 years. The initial blood glucose was 546.4 ± 296.3 mg/dl. The initial anion gap was 31.8 ± 7.8 meq/l. The mean time to anion gap closure twice was 19.2 ± 12.8 hours. The mean fluid administered until anion gap closure was 3694.9 ± 2484.6 ml. The insulin dose during the first day of management was 69.5 ± 49.9 units; the mean number of point-of-care glucose levels during the first 24 hours was 21.2 ± 6. The number of basic metabolic panels collected during hospital management was 12.2 ± 13.7. The mean ICU length of stay was 2.5 ± 3.8 days with no mortality. This study indicates that patients with diabetic ketoacidosis had a large number of basic metabolic panel tests and a large number of points of care glucose measurements using this protocol. This protocol needs review to determine whether or not the number of tests can be reduced, determine the outcome following among types of the IV fluid, the type of insulin and method administration during the management of DKA, and transfer out of the ICU can occur more quickly.

Hawa Edriss is a pulmonologist in Lexington, KY and has over 18 years of experience in the medical field. She has extensive experience in sleep apnea, obstructive lung disease, and pulmonary vascular conditions. She graduated from Eclectic Medicine University in 2005. She is affiliated with Saint Joseph Hospital. Her office accepts new patients.