Overview
Introduction
A person with diabetes may arrive profoundly acidotic while the glucose meter shows only 10 mmol/L.
A person with diabetes may arrive profoundly acidotic while the glucose meter shows only 10 mmol/L. That pattern is particularly dangerous after an SGLT2 inhibitor, during pregnancy, or after insulin was given before arrival: a reassuring glucose does not exclude diabetic ketoacidosis (DKA). DKA is an acute insulin-deficiency state in which counter-regulatory hormones drive ketone production and hyperglycemia. The resulting osmotic diuresis removes water and electrolytes, while the serum potassium may conceal a major total-body deficit. The nurse therefore watches three linked threats at once: impaired perfusion, falling potassium during insulin therapy, and worsening acidosis or neurological status.