Diabetic emergencies in acute/critical care

Diabetic emergencies are a fairly common occurrence in acute medical care. In particular, diabetic keto-acidosis (DKA) and hyper-osmolar non-ketotic states are potentially fatal conditions. A patient may present in a grossly obtunded state with profound metabolic derangement. In DKA, arterial blood gas (ABG) analysis may reveal a pH of less than 7.0. This degree of acidosis is generally non-survivable with any other cause, however with DKA, prompt appropriate treatment and close monitoring usually results in a rapid and full recovery. The importance of good glycaemic control in the context of acute myocardial ischaemia and general critical illness is also discussed.