An updated guideline from the Joint British Diabetes Society for Inpatient Care regarding the management of diabetic ketoacidosis in adults


eMediNexus    15 December 2022

The updated guideline for managing diabetic ketoacidosis in adults considers new evidence on the use of the previous version of this document, particularly the high prevalence of hypoglycemia and hypokalaemia. 


The highlights of the document are as follows-


  • Ketoacidosis is a potentially life-threatening condition. The previous version of this guideline was extensively used across the United Kingdom and elsewhere. However, evidence on the prevalence of hypoglycemia and hypokalaemia demanded modifications.
  • This guideline clearly directs on using a pediatric guideline or the present guideline when a person aged 16–18 years old is under the care of the pediatric team or an adult team, respectively.
  • It recommends de-escalating the insulin infusion rate from 0.1 to 0.05 units/kg/h when the blood glucose falls below 14 mmol/L.
  • It also includes sections that illustrate the management of euglycaemic ketoacidosis using SGLT-2 inhibitors, ketosis-prone type 2 diabetes, and ketoacidosis in people with end-stage renal failure or on dialysis.


Dhatariya KK, The Joint British Diabetes Societies for Inpatient Care. The management of diabetic ketoacidosis in adults—An updated guideline from the Joint British Diabetes Society for Inpatient Care. Diabetic Medicine. 2022;39(6):e14788. https://doi.org/10.1111/dme.14788

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