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
Speakers
-
Professor Ketan Dhatariya
Consultant in diabetes and endocrinology, honorary professor of medicine
Professor Ketan Dhatariya graduated from the University of London in 1991 and did his diabetes and endocrinology training in and around London. For 2 years during his training he was also a part time General Practitioner in the evenings. He took some time out of his training to spend a year doing intensive care medicine and anaesthetics. After he finished his diabetes training in 2001 he went to do a 2 year research fellowship in endocrinology at Mayo Clinic in Minnesota, USA. He was appointed as a consultant in diabetes, endocrinology and general medicine at the Norfolk & Norwich University Hospital in 2004, and Honorary Professor of Medicine at the University of East Anglia in 2019.
He is a full time NHS clinician, with no dedicated research time or funding. His predominant areas of interest are inpatient diabetes – in particular peri-operative diabetes care, the management of diabetes related emergencies, and the ‘diabetic foot’. He leads one of the largest foot clinics in the East of England.
He has several national roles in the UK. He is currently the Chair of the Association of British Clinical Diabetologists and is also the immediate past chair of the Joint British Diabetes Societies Inpatient Care Group where he led or co-authored several national guidelines on the management of various aspects of inpatient diabetes care. He is the Chair of the Examining Board for the UK Specialist Clinical Exam in Diabetes and Endocrinology. He is also the immediate past President of the Diabetes and Endocrine section of the Royal Society of Medicine. He is the Section Co-editor for diabetes for Endotext.org He is an Associate Editor of Diabetic Medicine and, until 2023 was also an Associate Editor of BMJ Open Diabetes Research & Care.
Professor Dhatariya has over 185 peer reviewed publications, and has published over 20 book chapters on inpatient diabetes, peri-operative diabetes care or on the diabetic foot. He has been named as one of the world’s leading diabetes experts by ExpertScape.com -
Professor Mark William John Strachan
Consultant Physician in Diabetes & Endocrinology
Mark Strachan is a consultant in Diabetes, Endocrinology and Acute Medicine at the Western General Hospital, Edinburgh and Honorary Professor of the University of Edinburgh. He runs the monogenic diabetes service in Lothian and has a particular interest in C-peptide and its role as a means of more accurately classifying the underlying cause of diabetes. He has published widely on the effects of Type 2 diabetes on cognitive function and liver disease, and was previously awarded the RD Lawrence Lectureship by Diabetes UK.
Outwith diabetes, he leads the South East Scotland thyroid cancer and neuroendocrine cancer services. He is Treasurer of the British Thyroid Foundation and a Trustee and Founder of the Ann Edgar Charitable Trust for patients with neuroendocrine cancers.
He is Secretary of the Royal College of Physicians of Edinburgh and former President of the Scottish Society of Physicians. He is an editor of the international textbook ‘Davidson’s Principles and Practice of Medicine.’
