A diabetic undergoing surgery may be at risk for developing ketoacidosis (DKA).

Patient selection: surgical


Risk factors for diabetic ketoacidosis:

(1) therapy with a sodium-glucose cotransporter 2 inhibitor

(2) prolonged fasting

(3) interruption of insulin therapy

(4) type of surgery (bariatric, cardiac, thoracic)

(5) failure to monitor blood glucose

(6) dehydration

(7) acute illness prior to surgery, including infection

(8) failure to test for blood or urine ketones

(9) undiagnosed diabetes


Euglycemic diabetic ketoacidosis may go unrecognized.

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