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On Demand Webinar: History and management of diabetic ketoacidosis



In the first of our 2022 ABCD webinar series, which run on the first Thursday of the month, please join Professor Ketan Dhatariya to discuss the history and management of ketoacidosis.

Prior to the discovery of insulin, type 1 diabetes was universally fatal within a few months. Insulin revolutionised the world of diabetes. However, it took a long time to understand how insulin should be used, and at what doses. Of course the manufacturing process has also progressed to enable the use of human and then analogue insulins. This talk will go through the early studies on the management of DKA and how the use of hundreds, or even thousands of units given intramuscularly was common place. Then, in the 1970’s, seminal papers showed that low dose intravenous insulin was just as good in lowering glucose and ketone concentrations. The slow, and gentle evolutions have led to the current guidelines.

There remain many areas of uncertainty – the US and the UK guidelines differ – and it may be argued that the ADA guidelines are no longer fit for purpose. There are few studies ongoing to help inform clinical practice. However, with the availability of IT and large data gathering capability, there is new hope that evidence will inform the next versions of the guidelines rather than expert opinion. The outlook for the management of DKA looks good.

Q & A will follow this presentation

his meeting has been approved by the Federation of the Royal Colleges of Physicians of the United Kingdom for 1 category 1 (external) credit (ref: 136

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