Guidelines
- Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009 Jul;32(7):1335-43. doi: 10.2337/dc09-9032. PMID: 19564476; PMCID: PMC2699725.
- Scott AR, Diabetes UK: Position statement: management of hyperosmolar hyperglycemic state in adults with diabetes. Diabet Med 2015; 32: pp. 714-724.
Primary Literature
Fluids
- Chua HR, Venkatesh B, Stachowski E, Schneider AG, Perkins K, Ladanyi S, Kruger P, Bellomo R. Plasma-Lyte 148 vs 0.9% saline for fluid resuscitation in diabetic ketoacidosis. J Crit Care. 2012 Apr;27(2):138-45. doi: 10.1016/j.jcrc.2012.01.007. PMID: 22440386.
- Williams V, Jayashree M, Nallasamy K, Dayal D, Rawat A. 0.9% saline versus Plasma-Lyte as initial fluid in children with diabetic ketoacidosis (SPinK trial): a double-blind randomized controlled trial. Crit Care. 2020 Jan 2;24(1):1. doi: 10.1186/s13054-019-2683-3. PMID: 31898531; PMCID: PMC6939333.
- Self WH, Evans CS, Jenkins CA, et al; Pragmatic Critical Care Research Group. Clinical Effects of Balanced Crystalloids vs Saline in Adults With Diabetic Ketoacidosis: A Subgroup Analysis of Cluster Randomized Clinical Trials. JAMA Netw Open. 2020 Nov 2;3(11):e2024596. Insulin
- Van Zyl DG, Rheeder P, Delport E. Fluid management in diabetic-acidosis–Ringer’s lactate versus normal saline: a randomized controlled trial. QJM. 2012 Apr;105(4):337-43. doi: 10.1093/qjmed/hcr226. Epub 2011 Nov 22. PMID: 22109683.
- Mahler SA, Conrad SA, Wang H, Arnold TC. Resuscitation with balanced electrolyte solution prevents hyperchloremic metabolic acidosis in patients with diabetic ketoacidosis. Am J Emerg Med. 2011 Jul;29(6):670-4. doi: 10.1016/j.ajem.2010.02.004. Epub 2010 May 1. PMID: 20825879.
Insulin
- Umpierrez GE, Cuervo R, Karabell A, Latif K, Freire AX, Kitabchi AE. Treatment of diabetic ketoacidosis with subcutaneous insulin aspart. Diabetes Care. 2004 Aug;27(8):1873-8. doi: 10.2337/diacare.27.8.1873. PMID: 15277410.
- Umpierrez GE, Latif K, Stoever J, Cuervo R, Park L, Freire AX, E Kitabchi A. Efficacy of subcutaneous insulin lispro versus continuous intravenous regular insulin for the treatment of patients with diabetic ketoacidosis. Am J Med. 2004 Sep 1;117(5):291-6. doi: 10.1016/j.amjmed.2004.05.010. PMID: 15336577.
- Ersöz HO, Ukinc K, Köse M, Erem C, Gunduz A, Hacihasanoglu AB, Karti SS. Subcutaneous lispro and intravenous regular insulin treatments are equally effective and safe for the treatment of mild and moderate diabetic ketoacidosis in adult patients. Int J Clin Pract. 2006 Apr;60(4):429-33. doi: 10.1111/j.1368-5031.2006.00786.x. PMID: 16620355.
- Goyal N, Miller JB, Sankey SS, Mossallam U. Utility of initial bolus insulin in the treatment of diabetic ketoacidosis. J Emerg Med. 2010 May;38(4):422-7. doi: 10.1016/j.jemermed.2007.11.033. Epub 2008 Jun 2. PMID: 18514472.
- Shankar V, Haque A, Churchwell KB, Russell W. Insulin glargine supplementation during early management phase of diabetic ketoacidosis in children. Intensive Care Med. 2007 Jul;33(7):1173-1178. doi: 10.1007/s00134-007-0674-3. Epub 2007 May 17. PMID: 17508198.
- Razavi Z, Maher S, Fredmal J. Comparison of subcutaneous insulin aspart and intravenous regular insulin for the treatment of mild and moderate diabetic ketoacidosis in pediatric patients. Endocrine. 2018 Aug;61(2):267-274. doi: 10.1007/s12020-018-1635-z. Epub 2018 May 24. PMID: 29797212.
- Andrade-Castellanos CA, Colunga-Lozano LE, Delgado-Figueroa N, Gonzalez-Padilla DA. Subcutaneous rapid-acting insulin analogues for diabetic ketoacidosis. Cochrane Database Syst Rev. 2016 Jan 21;(1):CD011281. doi: 10.1002/14651858.CD011281.pub2. PMID: 26798030.
- Umpierrez GE, Jones S, Smiley D, Mulligan P, Keyler T, Temponi A, Semakula C, Umpierrez D, Peng L, Cerón M, Robalino G. Insulin analogs versus human insulin in the treatment of patients with diabetic ketoacidosis: a randomized controlled trial. Diabetes Care. 2009 Jul;32(7):1164-9. doi: 10.2337/dc09-0169. Epub 2009 Apr 14. PMID: 19366972; PMCID: PMC2699711.
- Rappaport SH, Endicott JA, Gilbert MP, Farkas JD, Clouser RD, McMillian WD. A Retrospective Study of Early vs Delayed Home Dose Basal Insulin in the Acute Management of Diabetic Ketoacidosis. J Endocr Soc. 2019 Apr 11;3(5):1079-1086. doi: 10.1210/js.2018-00400. PMID: 31069278; PMCID: PMC6500796.
- Mohamed A, Ploetz J, Hamarshi MS. Evaluation of Early Administration of Insulin Glargine in the Acute Management of Diabetic Ketoacidosis. Curr Diabetes Rev. 2021;17(8):e030221191986. doi: 10.2174/1573399817666210303095633. PMID: 33655870.
- Harrison VS, Rustico S, Palladino AA, Ferrara C, Hawkes CP. Glargine co-administration with intravenous insulin in pediatric diabetic ketoacidosis is safe and facilitates transition to a subcutaneous regimen. Pediatr Diabetes. 2017 Dec;18(8):742-748. doi: 10.1111/pedi.12462. Epub 2016 Nov 3. PMID: 27807910; PMCID: PMC5415439.
Sodium Bicarbonate
- Green SM, Rothrock SG, Ho JD, Gallant RD, Borger R, Thomas TL, Zimmerman GJ. Failure of adjunctive bicarbonate to improve outcome in severe pediatric diabetic ketoacidosis. Ann Emerg Med. 1998 Jan;31(1):41-8. doi: 10.1016/s0196-0644(98)70279-3. PMID: 9437340.
- Hale PJ, Crase J, Nattrass M. Metabolic effects of bicarbonate in the treatment of diabetic ketoacidosis. British Medical Journal Clinical Research Ed. 1984;289:1035–1038. doi: 10.1136/bmj.289.6451.1035.
- Morris LR, Murphy MB, Kitabchi AE. Bicarbonate therapy in severe diabetic ketoacidosis. Annals of Internal Medicine. 1986;105:836–840.
- Gamba G, Oseguera J, Castrejon M, Gomez-Perez FJ. Bicarbonate therapy in severe diabetic ketoacidosis. A double blind, randomized, placebo controlled trial. Revista de Investigacion Clinica. 1991;43:234–238.
- Lutterman JA, Adriaansen AA, van ‘t Laar A. Treatment of severe diabetic ketoacidosis. A comparative study of two methods. Diabetologia. 1979;17:17–21.
- Lever E, Jaspan JB. Sodium bicarbonate therapy in severe diabetic ketoacidosis. American Journal of Medicine. 1983;75:263–268. doi: 10.1016/0002-9343(83)91203-2.
- Viallon A, Zeni F, Lafond P, Venet C, Tardy B, Page Y, Bertrand JC. Does bicarbonate therapy improve the management of severe diabetic ketoacidosis? Critical Care Medicine. 1999;27:2690–2693.
- Okuda Y, Adrogue HJ, Field JB, Nohara H, Yamashita K. Counterproductive effects of sodium bicarbonate in diabetic ketoacidosis. Journal of Clinical Endocrinology & Metabolism. 1996;81:314–320.
- Green SM, Rothrock SG, Ho JD, Gallant RD, Borger R, Thomas TL, Zimmerman GJ. Failure of adjunctive bicarbonate to improve outcome in severe pediatric diabetic ketoacidosis. Annals of Emergency Medicine. 1998;31:41–48.
Review Articles
- Chua HR, Schneider A, Bellomo R. Bicarbonate in diabetic ketoacidosis – a systematic review. Ann Intensive Care. 2011 Jul 6;1(1):23. doi: 10.1186/2110-5820-1-23. PMID: 21906367; PMCID: PMC3224469.
- Duhon B, Attridge RL, Franco-Martinez AC, Maxwell PR, Hughes DW. Intravenous sodium bicarbonate therapy in severely acidotic diabetic ketoacidosis. Ann Pharmacother. 2013 Jul-Aug;47(7-8):970-5. doi: 10.1345/aph.1S014. Epub 2013 Jun 4. PMID: 23737516.
- Maletkovic J, Drexler A: Diabetic ketoacidosis and hyperglycemic hyperosmolar state. Endocrinol Metab Clin North Am 2013; 42: pp. 677-695.
- Pasquel FJ, Umpierrez GE: Hyperosmolar hyperglycemic state: a historic review of the clinical presentation, diagnosis and treatment. Diabetes Care 2014; 37: pp. 3124-3131.
- Cornwell B, Knight B, Olivieri L, et. al.: Current diagnosis and treatment of hyperglycemic emergencies. Emerg Med Clin North Am 2014; 32: pp. 437-452.
- Goldenberg RM, Berard LD, Cheng AY, et. al.: SGLT2 inhibitor-associated diabetic ketoacidosis: clinical review and recommendations for prevention and diagnosis. Clin Ther 2016; 38: pp. 2654-2664.
- Tran TTT, Pease A, Wood AJ, Zajac JD, Mårtensson J, Bellomo R, Ekinci EII. Review of Evidence for Adult Diabetic Ketoacidosis Management Protocols. Front Endocrinol (Lausanne). 2017 Jun 13;8:106. doi: 10.3389/fendo.2017.00106. Erratum in: Front Endocrinol (Lausanne). 2017 Jul 31;8:185. PMID: 28659865; PMCID: PMC5468371.
