Highlights
- •We present the pathophysiology, clinical presentations, and management considerations for ketoacidosis related to sodium-glucose cotransporter 2 inhibitors, pregnancy, fasting, and alcoholic acidosis.
Abstract
Diabetic ketoacidosis (DKA) is a common and generally well-understood medical condition
in urgent and acute care centers. There are numerous conditions that have similar
presentations to DKA but are better served with different treatment modalities. This
article discusses the clinical presentation, diagnostic criteria, and management pearls
of euglycemic DKA, alcoholic acidosis, fasting ketosis, and ketosis of pregnancy to
help the reader more clearly distinguish between conditions to optimize patient care
and outcomes.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The Journal for Nurse PractitionersAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Euglycemic diabetic ketoacidosis: etiologies, evaluation, and management.Am J Emerg Med. 2021; 44: 157-160https://doi.org/10.1016/j.ajem.2021.02.015
- Ketoacidosis associated with SGLT2 inhibitor treatment: analysis of FAERS data.Diabetes Metab Res Rev. 2017; 33 (10.1002/dmrr.2924)https://doi.org/10.1002/dmrr.2924
- Euglycemic diabetic ketoacidosis.Eur J Intern Med. 2019; 63: 9-14
- Euglycemic diabetic ketoacidosis: a predictable, detectable, and preventable safety concern with SGLT2 inhibitors.Diabetes Care. 2015; 38: 1638-1642
- SGLT2 inhibitor-induced euglycemic diabetic ketoacidosis: a case report.Kidney Med. 2020; 2: 218-221https://doi.org/10.1016/j.xkme.2019.12.006
- Euglycemic Diabetic Ketoacidosis.StatPearls Publishing, 2022
- Alcoholic ketocacidosis: etiologies, evaluation, and management.J Emerg Med. 2021; 61: 658-665
- Alcohol ketoacidosis.Endocrinol Metab Clin North Am. 1991; 22: 209-219
- Alkoholketoacidos är en väl dokumenterad men tämligen okänd diagnos - Möjlig orsak till dödsfall bland personer med alkoholproblem [in Swedish].Lakartidningen. 2017; 114: EP6D
- Wolfson A.B. Hendey G.W. Ling L.J. Harwood-Nuss' Clinical Practice of Emergency Medicine. 5th ed. Lippincott, Williams and Wilkins, 2010: 1019-1021
- Ketone body on maternal and infant outcome of pregnant women with abnormal glucose metabolism during pregnancy.Diabetes Metab Syndr Obes. 2020; 13: 4581-4588https://doi.org/10.2147/DMSO.S280851
- Dietary Guidelines for Americans, 2020-2025. 9th ed. US Department of Agriculture and US Department of Health and Human Services, 2020
- Overweight and diabetes prevention: is a low-carbohydrate–high-fat diet recommendable?.Eur J Nutr. 2018; 57: 1301-1312
- Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets.Eur J Clin Nutr. 2013; 67: 789-796
- Nutrition therapy for adults with diabetes or prediabetes: a consensus report.Diabetes Care. 2019; 42: 731-754
Biography
Elizabeth Bell-McClure, DNP, FNP is a clinical associate at Duke University School of Nursing in Durham, NC, and can be contacted at [email protected]
Biography
Valerie Sabol, PhD, ACNP-BC, GNP-BC, CNE is a professor at Duke University School of Nursing.
Biography
Kristen McMillan, MSN, FNP-C ia an NP at Duke University Medical Center, Durham, NC.
Article info
Publication history
Published online: December 12, 2022
Publication stage
In Press Corrected ProofFootnotes
In compliance with standard ethical guidelines, the authors report no relationships with business or industry that would pose a conflict of interest.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
