Treatment of Type 1 Diabetes in Diabetic Ketoacidosis with Shock, Reduced Consciousness, or Coma
This protocol applies to type 1 diabetes presenting in diabetic ketoacidosis (DKA) when haemodynamic or neurological compromise is present — a high-acuity situation requiring immediate structured intervention.
Clinical Scenario
The patient has diabetic ketoacidosis with one or more of the following features:
- Shock — reduced peripheral pulses
- Reduced consciousness or coma
Primary Clinical Goal
Restoration of circulation
Treatment Approach
Management centres on immediate resuscitation, with prioritised attention to airway, breathing, and circulatory support in sequence.
The full step-by-step regimen — including specific interventions, decision thresholds, and sequencing — is available in the structured protocol below.
References
DOI: 10.1016/j.jcjd.2017.10.036
- Shock (reduced peripheral pulses)
- Reduced consciousness or coma
- Airway / nasogastric tube
- Breathing (100% O2)
- Circulation (0.9% NaCl 10-20 ml/kg over 1-2 h, repeat until circulation is restored, but do not exceed 30 ml/kg)
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