Diabetic ketoacidosis

Diabetic ketoacidosis is characterized by insulin deficiency, which permits the release of massive amounts of fatty acids from the fat cell, and by glucagon excess, which orchestrates the conversion of fatty acids into ketoacids in the liver. Low insulin and high glucagon also lead to increased hepatic glucose production. Therapy is directed towards the developing indications of systemic acidosis, hyperglycemia, osmotic diuresis, and dehydration by administration of fluid, electrolytes, and insulin; the precipitating cause of each episode must be sought and treated simultaneously.