Diabetic Ketoacidosis in the Adult Patient

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Target Audience: This educational activity is designed for pharmacists who treat patients with diabetes.

Program Goal: This monograph is a review of the pathophysiology, diagnosis, treatment, and complications of diabetic ketoacidosis (DKA) in adults.

Program Overview: DKA is a life-threatening complication of diabetes that is caused by relative or absolute insulin deficiency, which results in hyperglycemia, ketonemia, dehydration, electrolyte imbalances, and acidosis. Treatment protocols for adults generally advocate a more rapid and aggressive reversal of DKA than is advised for children.¹ DKA consumes a significant proportion of all direct medical costs for adults and children with type 1 diabetes. The management of DKA requires a full complement of hospital, emergency, and intensive care services. In the United States, more than 100,000 individuals are hospitalized each year for DKA and the mortality rate is 2% to 5%.

Most cases of DKA can be prevented by using an effective diabetes management plan that includes patient self-care. Early identification of precipitating signs and symptoms and prompt, appropriate intervention can reduce the frequency of DKA episodes that result in a medical emergency.

The healthcare team must stay informed about the recent developments in diabetes care and have the necessary clinical skills to prevent and manage DKA episodes. Through good self-management and intensive glycemic control, the incidence, morbidity, and mortality of DKA can be reduced.

Educational Objectives: Upon completion of this activity, participants should be able to:

Continuing Pharmaceutical Education: Novo Nordisk Pharmaceuticals, Inc. is approved by the American Council on Pharmaceutical Education (ACPE) as a provider of continuing pharmaceutical education.

This program has been assigned the Universal Program Number 360-999-01-002-H01 and is acceptable for 1.8 contact hours (.18 CEUs) in states that recognize ACPE-approved providers.

In order to receive credit, participants must read the entire monograph, complete and submit an evaluation, and score at least 70% on the self-assessment test. A statement of credit will be issued only upon receipt of a successfully completed post-test (70% or better) and activity evaluation form.

Release Date: July 1, 2002
Expiration Date: July 1, 2005

Fee: There is no fee to receive credits for this continuing education activity.

Editorial Review Board:

John B. Buse, MD, PhD, CDE
Chief, Division of General Internal Medicine
Director, Diabetes Care Center
University of North Carolina School of Medicine
Chapel Hill, North Carolina

Thomas S. Sisca, PharmD, FCCP, BCPS
Clinical Manager, Pharmacy
Memorial Hospital
Easton, Maryland

Marsha Menke, RN, BSN, MS, CDE, CPT
Director
Diabetes Care Center
Genesis Medical Center
Davenport, Iowa

Disclosure Declaration: It is the policy of Novo Nordisk Pharmaceuticals, Inc. and the Postgraduate Institute for Medicine to ensure independence, balance, objectivity, scientific rigor, and integrity in all of their continuing education activities. The faculty must disclose to the participants any significant relationships with the commercial companies whose products or devices may be mentioned in the activity or with the supporter of this continuing education activity. The information is for participant information; it is not assumed that these relationships will have a negative impact on the content of the activity.

Dr. Buse has disclosed the following financial relationships: research grants from Eli Lilly and Company.

Dr. Sisca has disclosed that he has no financial relationships to report.

Ms. Menke has disclosed that she has no financial relationships to report.

Disclaimers:

• Approval of credit for this continuing education program does not imply endorsement by Novo Nordisk Pharmaceuticals, Inc. and the Postgraduate Institute for Medicine of any product or manufacturer identified.
• Any medications or treatment methods suggested in this CE activity should not be used by the practitioner without evaluation of their patient's condition(s) and possible contraindication(s) or danger(s) of use of any specific medication.
• This activity may include discussions of products or devices that are not currently approved for use by the Food and Drug Administration (FDA).
• Novo Nordisk Pharmaceuticals, Inc., the Postgraduate Institute for Medicine, and the activity's faculty do not endorse the use of any product in a manner that is not approved by the FDA.

  The author, sponsor, and publisher of this continuing education program have made all reasonable efforts to ensure that information contained herein is accurate in accordance with the latest available scientific knowledge at the time of accreditation of this continuing education program. Information regarding drugs (e.g., their administration, dosages, contraindications, adverse reactions, interactions, special warnings, precautions) and drug delivery systems is subject to change, however, and the reader is advised to check the manufacturer's package insert for information concerning recommended dosage and potential problems or cautions prior to dispensing or administering the drug or using the drug delivery systems

Commercial Support: This continuing education activity is supported by an unrestricted educational grant from Novo Nordisk Pharmaceuticals, Inc.

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Copyright© 2002, Novo Nordisk Pharmaceuticals, Inc. All rights reserved.

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