Cerebral oedema in diabetic ketoacidosis

Modern management of diabetic ketoacidosis has reduced mortality of this condition from inevitable death in the pre-insulin era to less than 5% in specialised centres. Most fatalities now reflect the underlying disease which has caused metabolic decompensation, such as acute myocardial infarction, cerebrovascular accident or septicaemia. However patients may still die as a direct result of the metabolic disturbances per se and the rare complication of cerebral oedema in diabetic ketoacidosis is almost invariably associated with fatal outcome.