Diabetic ketoacidosis

SummaryDiabetic ketoacidosis (DKA) remains the commonest cause of diabetes-related deaths in children and most deaths occur as a result of cerebral oedema. There are now internationally agreed guidelines for the management of DKA, which aim to optimise treatment and to minimise the risk of complications including cerebral oedema. Much of the guidance is consensus rather than evidence based, but knowledge of the pathophysiology, the evolving clinical presentation and the existing evidence supporting management strategies helps us to understand the rationale behind the consensus guidelines for the management of DKA.