[Diabetic ketoacidosis: diagnosis, management, prevention]

Diabetic ketoacidosis results from relative or absolute deficiency of insulin and is a frequent metabolic emergency. It occurs in previously undiagnosed diabetes, in half of the cases in Europe, or is the consequence of a severe unbalance in a well-known diabetic patient, who, deliberately or not, does not take enough or not at all insulin. In population studies, the mortality rate in children ranges from 0,15% to 0,30%, cerebral edema accounts for 60% to 90%. Three stages are described: ketosis, ketoacidosis, ketoacidotic coma. This paper summarizes the physiopathology as well as the clinical and biological signs. It opens up an algorithm for the management of diabetic ketoacidosis and its complications and indicates prevention methods.