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Pilot Study Of Guideline Adherence And Secondary Outcomes In Patients Presenting With Diabetic Ketoacidosis

Background: The 2010 American Diabetic Association (ADA) Guidelines for management of diabetic ketoacidosis (DKA) recommend treatment of DKA in a timely manner. Objective: We sought to explore the quality of emergency department (ED) DKA management by comparing ED DKA management with standard ADA guidelines beyond the initial management. Materials and Methods: This study was a retrospective study at an academic ED. Patients age ≥ 18 years who were evaluated and treated for DKA were included. We compared ED DKA management with standard ADA guidelines in four aspects: (1) fluid administration, (2) insulin administration, (3) electrolyte correction, and (4) ED disposition. Secondary outcomes were hypoglycemia, restarting of continuous insulin infusion (CII), and rebound hyperglycemia within 24 hours. Results: Of 75 enrolled patients, 29(39%) had mild, 16(21%) had moderate, and 30(40%) had severe DKA. All patients received intravenous fluid during their ED stay. Seventy five (100%) of cases received insulin administration in the ED. Twenty-four (44%) of cases received potassium supplement. Dextrose containing fluids was administered in 24/58(41%) of cases where blood glucose dropped Continue reading >>

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Popular Questions

  1. [deleted]

    I have had a terrible time sleeping since being on Keto, specifically in the last week. I do not want to stop though, I've lost 8 lbs in 24 days, I'm starting to PR more, and there are moments of clarity where the brain fog is at a minimum.
    NOTHING seems to keep me asleep. Usually I fall asleep in seconds and wake up 4 hours later wide awake but now I cannot even fall asleep. I try not to drink too much water before bed, exercise earlier in the afternoons 2-4 times a week, keep the tv/ smartphone out of the bedroom, and give myself some wind down time. I take the lowest does of Topamax for headaches and Alteril as a sleep aid. Any advice? Does this go away? I've been on some psych meds before for sleep, but none of them are truly designed to keep you asleep, only help you fall asleep.
    If you have any suggestions, I'd really appreciate it. I'm taking in about 70-90 grams of protein per day to keep my muscle mass, but I may have to down grade as protein can keep you awake.
    Thanks for any help you can give me.

  2. DownhillYardSale

    I've been on some psych meds before for sleep, but none of them are truly designed to keep you asleep, only help you fall asleep.
    Why?
    If this is the case keto isn't the cause of your sleep problems.
    I'm immediately looking towards stress/anxiety.

  3. DownhillYardSale

    You do not need to have mental health issues for stress/anxiety to affect your sleep.
    Any significant changes recently other than completely changing your diet?

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