Diabetic ketoacidosis (DKA) results from absolute or relative insulin deficiency, causing the body to break down fat for energy, producing ketone bodies that acidify the blood. It predominantly affects type 1 diabetes but occurs in type 2 diabetes under physiological stress. The triad of hyperglycaemia (typically >250 mg/dL), ketosis, and metabolic acidosis (pH <7.3, bicarbonate <18 mmol/L) defines DKA. Management requires aggressive intravenous fluid resuscitation, continuous low-dose insulin infusion, potassium replacement, and identification and treatment of the precipitating cause — most commonly missed insulin doses, infection, or new-onset diabetes. Cerebral oedema — a rare but potentially fatal complication — is more common in children and young adults.
