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Evaluation and Treatment of Diabetic Ketosis without Acidosis — Initial Assessment — Clinical Pathway: Inpatient

Diabetic Ketosis without Acidosis Clinical Pathway — Inpatient

Initial Assessment

Diabetic patients with elevated blood glucose > 300 or who present with inter-current illness should be assessed for diabetic ketosis without acidosis (DK no A) by testing for blood or urine ketones.

Please discuss with family that home care and hospital care may differ.

Contact Endocrinology if there are concerns.

Complete History and Physical

History
  • Review recent glucose values
  • Prior ketone measurements
  • Review recent insulin administration
  • Presence of insulin pump
    • Check last site change
  • Total daily insulin dose, home insulin doses
  • Assess risk for dehydration
  • Infectious symptoms
Physical

Check blood or urine ketones

5S/5WB/ED
  • Use bedside blood ketone meters for ketone check
All Other Inpatient Units
  • Send urine for ketones
  • OR
  • Send blood for beta-hydroxybutyrate (BOHB) test for serum ketones
All Units

 

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