Diabetic ketoacidosis and hypoglycemia management interventions in the emergency department

Among patients with diabetes mellitus, hypoglycemia, and hyperglycemia crises are the most frequent acute consequences. One avoidable cause of death, illness, and decreased quality of life is hypoglycemia. The chance of having hypoglycemia doubles beyond the age of 60 years, making it more prevalent among older persons. With advancing age and a history of severe hypoglycemia, hypoglycemia is linked to death rates that increase two to three times. This study aimed to present evidence on the effectiveness of treatments used in the emergency management of diabetic ketoacidosis (DKA) and hypoglycemia. The PRISMA statement was followed in the conduction of this study. The comparators for either hypoglycemia or DKA were excluded from the search strategy to prevent restricting the search results. Randomized controlled trials and cohort studies were considered, and only English-language articles were selected. The electronic health databases Medline, Cochrane, and Embase were searched for relevant content between the years 2019 and 2024. It was found that hypoglycemia can be effectively treated with both 10% and 50% dextrose. Sodium chloride and playmate-based fluid treatment had a greater impact, shortened hospital stays, and DKA recovery times. Similarly, a potassium content below 10 mmol/l raises mortality, and excessive use of fluids containing chloride was linked to prolonged hospital stays and a higher risk of comorbidities.