Diabetic ketoacidosis is a severe, life-threatening complication of diabetes characterized by uncontrolled hyperglycemia, metabolic acidosis, and ketone production. Patients with severe DKA often require ICU admission due to profound metabolic derangements, dehydration, electrolyte imbalance, and risk of rapid deterioration. DKA is most commonly seen in type 1 diabetes but can also occur in type 2 diabetes under extreme stress or infection.

Patients typically present with excessive thirst, frequent urination, abdominal pain, vomiting, rapid breathing, altered mental status, and signs of dehydration. In severe cases, DKA can progress to shock, cerebral edema, cardiac arrhythmias, and coma, making ICU-level care essential.

ICU management of DKA focuses on careful correction of metabolic abnormalities while avoiding treatment-related complications. Continuous insulin infusion is used to suppress ketone production and reduce blood glucose levels. Fluid resuscitation restores circulation and corrects dehydration, while electrolyte replacement addresses deficits caused by osmotic diuresis.

Frequent monitoring of blood glucose, electrolytes, acid-base status, and neurological function is critical. Rapid shifts in sodium or glucose levels can lead to cerebral edema, particularly in younger patients, necessitating cautious and protocol-driven management.

DKA often occurs in the context of infection, myocardial infarction, or other acute illness, requiring simultaneous management of the underlying trigger. ICU care ensures coordinated treatment and rapid response to complications.

With timely ICU intervention, most patients recover fully from DKA. Delayed or inadequate treatment, however, significantly increases mortality and long-term complications.