Detecting Diabetic Ketoacidosis with Infection: Combating a Life-Threatening Emergency with Practical Diagnostic...

Area of Science:

• Endocrinology and Diabetes Management
• Infectious Diseases
• Clinical Diagnostics

Background:

• Diabetic ketoacidosis (DKA) is a life-threatening diabetes mellitus complication with a 2-5% mortality rate.
• Infection is a primary trigger for DKA, accounting for approximately 50% of cases, often due to urinary tract infections or pneumonia.
• Distinguishing DKA with infection from DKA alone is vital to prevent unnecessary antibiotic use and combat antimicrobial resistance.

Purpose of the Study:

• To review septic markers for diagnosing infection in DKA patients.
• To differentiate DKA with infection from DKA without infection.
• To raise awareness about the severity of DKA with infection and the need for prompt diagnosis.

Main Methods:

• A narrative review of existing literature was conducted.
• Searches were performed on Google Scholar using keywords related to DKA, infection, and biomarkers.
• Relevant studies on Procalcitonin, inflammatory cytokines, lactic acidosis, and white blood cell counts in DKA were examined.

Main Results:

• DKA symptoms and infection biomarkers (e.g., fever, CRP, WBC) can overlap, complicating diagnosis.
• Bacterial cultures are confirmatory but time-consuming (up to 24 hours), delaying critical treatment.
• Identifying reliable biomarkers for infection in DKA is essential for immediate emergency room management.

Conclusions:

• Early and accurate diagnosis of infection in DKA is critical for effective management and improved patient outcomes.
• Biomarkers for infection in DKA can aid in timely treatment decisions, especially when bacterial culture results are pending.
• Further research into diagnostic tools for infection in DKA is warranted to optimize patient care and combat antibiotic resistance.