• Pablo Olmos, Aníbal Donoso, Juan Pablo Arab, Ian Niklitschek, Nicolás Mertens, Elizabeth Arce, Rosario Lemus, Valentina Serrano, Bruno Grassi, Kristel Strodthoff, Eduardo Abbott, Andrés Aizman, and María Verónica González.
• Rev Med Chil. 2014 Oct 1; 142 (10): 126712741267-74.

BackgroundDuring 2009, new guidelines for the treatment of diabetic ketoacidosis were published by the American Diabetes Association.AimTo assess the impact of new treatment guidelines on the evolution of patients treated for diabetic ketoacidosis (KAD).Patients And MethodsAnonymous data was obtained from computational medical records of patients treated for KAD at our institution two years before ("Traditional Protocol") and TWO years after ("ADA-2009 Protocol") the publication of the 2009 American Diabetes Association (ADA) KAD guidelines.ResultsTwenty three patients aged 36.5 ± 15.1 years were treated with the traditional method and 23 patients aged 44.4 ± 21.1 years were treated following 2009 ADA guidelines. Among patients treated with the traditional protocol and treated following ADA 2009 guidelines, the diabetes type 1/type 2 ratio was 18/5 and 19/16 respectively (p = NS), the glycosylated hemoglobin on admission was 12.6 ± 2.5 and 14.3 ± 2.7% respectively (p = 0.03), minimal blood pH was 7.15 ± 0.14 and 7.19 ± 0.09 respectively (p = NS), bicarbonate was required in seven and no patient respectively (p = 0.01), hypokalemia < 3.5 mEq/L occurred in 78.2 and 48.5% of patients (p = 0.03), the lapse until resolution was 28.7 ± 28.0 and 28.8 ± 20.6 hours (p = NS). Only one patient, treated following ADA 2009 guidelines, died.ConclusionsIntroduction of the ADA-2009 protocol for the treatment of KAD resulted in decrease in the use of intravenous bicarbonate and a reduction in the incidence of hypokalemia. There was no impact neither in the lapse until resolution or lethality.

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