Diabetic ketoacidosis (DKA), a life-threatening complication of Type 1 diabetes, is preventable but errors in the way it is managed are common and and associated with significant morbidity and mortality.
We've helped produce The Management of Diabetic Ketoacidosis in Adults, (PDF, 4MB) published by the Joint British Diabetes Societies Inpatient Care Group which includes recommendations to all diabetes hospital teams for managing DKA in adults.
Most acute hospitals have guidelines for how DKA is managed but it is not unusual to find these out of date and at variance to those of other hospitals.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 among 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.