Preventing Diabetic Ketoacidosis: An Early Intervention Approach On-Demand-DKA

Video Transcription

Video Summary

This webinar, presented by Professor Ketan Dattaria and Dr. Rodolfo Galindo, focuses on preventing diabetic ketoacidosis (DKA), a serious diabetes complication. They discuss ketone physiology—how ketones serve as an alternative energy source during carbohydrate scarcity—and pathophysiology, emphasizing the importance of insulin in regulating glucose and ketone production. They highlight recent consensus guidelines updating DKA diagnostic criteria: lowering hyperglycemia thresholds to glucose ≥200 mg/dL and emphasizing beta-hydroxybutyrate (≥3 mmol/L) over urine ketones for diagnosis and monitoring, due to accuracy issues with urine tests. Management prioritizes fluid resuscitation and insulin, noting the critical need for glucose-containing fluids to avoid hypoglycemia during insulin treatment. Subcutaneous insulin is viable for mild DKA. Continuous ketone monitoring technology is emerging, promising improved early detection and management by providing real-time ketone trends, aiding both patients and clinicians. Populations at greater risk for recurrent DKA include pregnant women, adolescents, those on SGLT2 inhibitors, and individuals with limited healthcare access or mental health conditions. The presenters stress ongoing education for patients and healthcare providers on sick day rules, ketone testing, and symptom recognition. Ultimately, integrating advanced monitoring with personalized clinical judgment can improve DKA prevention and outcomes.

Keywords

diabetic ketoacidosis

ketone physiology

insulin regulation

DKA diagnostic criteria

beta-hydroxybutyrate

fluid resuscitation

subcutaneous insulin

continuous ketone monitoring

high-risk populations