DIABETIC KETOACIDOSIS: A COMPREHENSIVE REVIEW OF PATHOPHYSIOLOGY, MANAGEMENT AND NEUROLOGICAL IMPACTS IN THE EMERGENCY SETTING

• DOI: https://doi.org/10.22533/at.ed.1594872424094

• Palavras-chave: Diabetes; ketoacidosis; emergency.

• Keywords: Diabetes; ketoacidosis; emergency.

• Abstract:

  Diabetic ketoacidosis (DKA) is a critical medical emergency associated with diabetes mellitus, especially type 1, which requires immediate treatment to avoid serious complications. The condition results from insulin deficiency, leading to uncontrolled hyperglycemia, excessive production of ketone bodies and metabolic acidosis. Initial treatment focuses on rapid correction of dehydration with isotonic saline solutions, blood glucose control and insulin administration, followed by a switch to glucose-containing solutions. Studies indicate that DKA can cause significant cognitive decline, especially in children, and suggest that factors such as cerebral hypoperfusion and neuroinflammation may be more relevant to brain damage than the rate of fluid administration. The review also highlights the importance of biomarkers, such as metalloproteinases, in understanding blood-brain barrier dysfunction. Effective treatment must consider both metabolic and neurological aspects to improve clinical outcomes.