Summary

• Diabetic ketoacidosis (DKA) is characterised by a biochemical triad of hyperglycaemia, ketonaemia, and acidaemia, with rapid symptom onset.
• An acute metabolic complication of diabetes that is potentially fatal if not properly treated.
• Common symptoms and signs include polyuria, polydipsia, polyphagia, weakness, weight loss, tachycardia, dry mucous membranes, poor skin turgor, hypotension, and, in severe cases, shock.
• Successful treatment includes correction of volume depletion, hyperglycaemia, electrolyte imbalances, and comorbid precipitating events, with frequent monitoring.
• Complications of treatment include hypoglycaemia, hypokalaemia, hypoxaemia, and rarely pulmonary oedema.
• Cerebral oedema, a rare but potentially rapidly fatal complication, occurs mainly in children. It is prevented by avoiding overly rapid fluid and electrolyte replacement.