Is there any updates after JBDS june 2021 DKA updates?
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diabetic ketoacidosis management guidelines
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JBDS DKA guidelines update 2022 2023 2024 Joint British Diabetes Societies diabetic ketoacidosis
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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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