A patient who has been treated for diabetic ketoacidosis is at risk for relapse if not properly managed.
Patient selection: diabetic ketoacidosis after discontinuation of initial management
The occurrence of a relapse is indicated by an increasing anion gap, often preceded by a rise in the blood glucose concentration.
Risk factors associated with a relapse of ketoacidosis:
(1) discontinuation of the insulin infusion early (before all of the endpoints have been reached)
(2) no or inadequate coverage by a long-acting insulin
(3) persistent acidosis
(4) inadequate oral intake to meet caloric needs
(5) ongoing systemic inflammation
(6) ongoing severe insulin resistance
