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The management of diabetic ketoacidosis in adults (September 2013)

Diabetic ketoacidosis (DKA), though preventable, remains a frequent and life threatening complication of type 1 diabetes. Unfortunately, errors in its management are not uncommon and importantly are associated with significant morbidity and mortality. Most acute hospitals have guidelines for the management of DKA but it is not unusual to find these out of date and at variance to those of other hospitals.

Even when specific hospital guidelines are available audits have shown that adherence to and indeed the use of these is variable amongst the admitting teams. These teams infrequently refer early to the diabetes specialist team and it is not uncommon for the most junior member of the admitting team, who is least likely to be aware of the hospital guidance, to be given responsibility for the initial management of this complex and challenging condition.

These guidelines, produced by the Joint British Diabetes Societies - Inpatient Care Group (JBDS-IP), are recommended to all diabetes hospital teams for rapid introduction and for acceptance as the national guidelines for managing DKA.

JBDS-IP is supported by Diabetes UK, the Association of British Clinical Diabetologists (ABCD) and the Diabetes Inpatient Specialist Nurse UK Group. The aim of JBDS-IP is to improve inpatient diabetes care throughout the UK. This is mainly through the development and use of high quality evidence based guidelines, and through better inpatient care pathways.  

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