Mendez Y, Surani S, Varon J. Diabetic ketoacidosis: Treatment in the intensive care unit or general medical/surgical ward? World J Diabetes 2017; 8(2): 40-44 [PMID: 28265341 DOI: 10.4239/wjd.v8.i2.40]
Corresponding Author of This Article
Salim Surani, MD, MPH, FACP, FCCP, Department of Medicine, University of North Texas, 1177 West Wheeler Ave, Aransas Pass, TX 78411, United States. srsurani@hotmail.com
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Feb 15, 2017; 8(2): 40-44 Published online Feb 15, 2017. doi: 10.4239/wjd.v8.i2.40
Diabetic ketoacidosis: Treatment in the intensive care unit or general medical/surgical ward?
Yamely Mendez, Salim Surani, Joseph Varon
Yamely Mendez, Dorrington Medical Associates, Houston, TX 77030, United States
Yamely Mendez, Facultad de Medicina, Universidad Autónoma de Tamaulipas Tampico, Tamps 8900, Mexico
Salim Surani, Department of Pulmonary, Critical Care and Sleep Medicine, Texas A and M University, Corpus Christi, TX 78404, United States
Salim Surani, Department of Medicine, University of North Texas, Aransas Pass, TX 78411, United States
Joseph Varon, Department of Critical Care Medicine, Foundation Surgical Hospital of Houston, Houston, TX 77054, United States
Author contributions: All authors contributed to this paper.
Conflict-of-interest statement: None of the authors have any conflict to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Salim Surani, MD, MPH, FACP, FCCP, Department of Medicine, University of North Texas, 1177 West Wheeler Ave, Aransas Pass, TX 78411, United States. srsurani@hotmail.com
Telephone: +1-361-8857722 Fax: +1-361-8507563
Received: August 16, 2016 Peer-review started: August 16, 2016 First decision: September 28, 2016 Revised: October 11, 2016 Accepted: November 21, 2016 Article in press: November 22, 2016 Published online: February 15, 2017 Processing time: 183 Days and 3.1 Hours
Abstract
Diabetic ketoacidosis (DKA) is defined as an acute metabolic disorder, which is characterized by an increased presence of circulating ketones, and the development of ketoacidosis in the presence of hyperglycemia. This syndrome occurs as a result of insulin deficiency. Patients can be dramatically ill, however, with aggressive treatment, most patients recover rapidly. Despite being a low-risk condition, the development of acidosis, is one of the admission criteria to the intensive care unit (ICU) for these patients, in order to provide close monitoring, and recognize complications that could result from the use of aggressive therapy, such as continuous infusions if insulin. In some institutions, DKA is treated in the emergency department and general medical/surgical wards to avoid ICU overcrowding.
Core tip: Diabetic ketoacidosis is a complication for some patients with insulin-dependent diabetes mellitus as well as for non-insulin dependent. It is treated commonly in the intensive care unit (ICU), even though clinical data from many studies support management in regular (medical/surgical) wards, avoiding expensive critical care unit costs and preventing bed crisis in these higher level of care units for sicker patients. Once the patient is treated, adequate follow up and education is mandatory. Noncompliance remains the primary concern for repeated admissions.
