Diabetes - acute complications

Short-term acute complications in diabetes include hypoglycaemia and diabetic ketoacidosis (DKA).

You can learn more about these acute complications in diabetes - signs and symptoms, and how to treat these emergencies in the RCN learning area Diabetes essentials: Emergency treatment for diabetes.

The resources below were last accessed on 1 November 2012. Some of them are in PDF format –see how to access PDF files.

BMJ: Factors associated with the presence of diabetic ketoacidosis at diagnosis of diabetes in children and young adults: a systematic review
The review concludes that "multiple factors affect the risk of developing diabetic ketoacidosis at the onset of type 1 diabetes in children and young adults, and there is potential time, scope, and opportunity to intervene between symptom onset and development of diabetic ketoacidosis for both parents and clinicians".

Diabetes UK: Complications - how to protect yourself
The Diabetes UK website has a series of pages on different complication. This includes:

Joint British Diabetes Societies (2010) The management of diabetic ketoacidosis in adults (PDF 324.8KB)
This guideline has been developed by a mutlidisciplinary group and is designed to provide guidance, based on evidence where possible, for inpatient care. It includes a DKA care pathway. This document is made available on the NHS Diabetes website.

NHS Diabetes (2012) Safe management of hypoglycaemia (SMH) e-learning module
The module is designed to improve knowledge and confidence in the safe and effective management of hypoglycaemia in healthcare professionals and people with diabetes and their families.

NHS Diabetes (2010) The hospital management of hypoglycaemia in adults with diabetes mellitus
This guideline has been developed by a multidisciplinary group of organisations and with the involvement of people with diabetes and is designed to be nurse led. It includes information on risk factors and potential causes of inpatient hypoglycaemia,and on the management and treatment of hypoglycaemia.

NHS Diabetes (2012) The management of the hyperosmolar hyperglycaemic state (HHS) in adults with diabetes (PDF 3.2MB)
The hyperosmolar hyperglycaemic state (HHS) is a medical emergency which does not have a precise definition but has key characteristics which differentiate it from diabetic ketoacidosis and which require a different approach in treatment. It typically occurs in older people but is presenting in ever younger adults and teenagers “often as an initial presentation of type 2 diabetes”. This guidance from the Joint British Diabetes Societies (JBDS) Inpatient Care Group describes the key characteristics of HHS and how it can be treated. It also looks at some of the controversial areas around management and treatment.
See also the accompanying JBDS guidance on the management of hyperosmolar hyperglycaemic state (HHS) in adults with diabetes (PDF 175.8KB).

NICE quality standard: Diabetes in adults
NICE quality standards are a concise set of statements designed to drive and measure priority quality improvements within a particular area of care.
Quality statement 14: Hypoglycaemia.
Quality statement 13: Diabetic ketoacidosis.