Is there any updates after JBDS june 2021 DKA updates?
Checking Date & Time
Reading File
Now let me search for updates to the JBDS DKA guidelines after June 2021, using both PubMed and web search in parallel.
Searching PubMed
diabetic ketoacidosis management guidelines
Searching the Web
JBDS DKA guidelines update 2022 2023 2024 Joint British Diabetes Societies diabetic ketoacidosis
The key result is right there — PMID 35224769: a 2022 JBDS updated DKA guideline published in Diabetic Medicine. Let me get the full abstract details, and also check the 2024 ADA/EASD consensus report on hyperglycaemic crises.
Reading Article
PMID: 35224769
Reading Article
PMID: 40032308
Excellent. I now have the two most relevant updates. Here is a comprehensive summary:
Updates to DKA Guidelines After JBDS June 2021
1. JBDS Updated DKA Guideline — 2022 ✅ (Direct Update)
Dhatariya KK & Joint British Diabetes Societies for Inpatient Care
Diabetic Medicine, June 2022 | PMID: 35224769 | DOI: 10.1111/dme.14788
Full guideline: abcd.care JBDS DKA Adults Guideline
This is the direct successor to the June 2021 document. Key changes:
| Area | Update |
|---|---|
| Insulin infusion rate | When glucose drops below 14 mmol/L, consider de-escalating insulin from 0.1 → 0.05 units/kg/h (to reduce hypoglycaemia and hypokalaemia risk) |
| Hypoglycaemia & hypokalaemia | Explicitly acknowledged as high-prevalence complications with the prior protocol; new dosing addresses this |
| SGLT-2 inhibitors | New dedicated section on euglycaemic ketoacidosis (euDKA) — recognising that SGLT-2 inhibitors increase euDKA risk (glucose may be <11 mmol/L despite DKA) |
| End-stage renal failure / dialysis | New guidance on managing DKA in this population |
| Algorithms | Updated flowcharts throughout |
| Age boundary | Clarified: age 16–18 under paediatric team → use paediatric guideline; under adult team → use this guideline |
2. ADA/EASD Consensus Report on Hyperglycaemic Crises — June 2024 🆕
Rodriguez Alvarez P et al.
Cleveland Clinic Journal of Medicine, March 2025 | PMID: 40032308
The American Diabetes Association published a major updated consensus report in June 2024 (the first update in 15 years). While this is a US/international document rather than JBDS-specific, it introduced:
- Revised diagnostic and resolution criteria for both DKA and HHS
- New assessment and management recommendations
- Updated prevention strategies
- Acknowledged the significant rise in DKA/HHS hospitalisations over the past decade
Also Relevant: JBDS HHS Guideline Update — 2023
Mustafa OG et al. Diabetic Medicine, March 2023 | PMID: 36370077
The companion JBDS guideline for Hyperosmolar Hyperglycaemic State (HHS) was also updated in 2023.
Summary
The most clinically significant JBDS-specific update is the 2022 revised DKA guideline, which primarily tightened insulin dose de-escalation to reduce iatrogenic hypoglycaemia/hypokalaemia and added formal guidance on SGLT-2 inhibitor–associated euglycaemic DKA. The 2024 ADA consensus is also worth reviewing for international alignment, particularly regarding updated diagnostic thresholds.
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