Diabetic ketoacidosis (DKA) is a serious complication of diabetes occurring when the body produces high levels of blood acids called ketones.
Patients with DKA present with hyperglycemia, severe dehydration and a metabolic acidosis. Although traditionally described in patients with type 1 diabetes, it is now recognised that patients with type 2 diabetes may also present with DKA.
Mackay Base Hospital’s Intensive Care Unit and Emergency Departments are currently involved in a state-wide research project on fluid management in DKA. The study will compare the use of saline with plasmalyte for fluid replacement in patients with DKA.
“There is some evidence out there that use of saline as fluid in DKA delays resolution of acidosis, which is intuitive as large volumes of saline will compound ketoacidosis with an additional hyperchloremic acidosis,” said Dr Stuart Baker.
“Use of more balanced solutions like CSL or plasmalyte presumably will improve rate of reversal of acidosis,” he said.
The study is a cluster-randomised controlled trial, meaning that sites are randomised to one solution for a fixed period in this case, six months. Prior to the assignment of the alternate fluid there will be a month long ‘washout period’.
“This is a very simple study, we have an idea that we should be using a more balanced solution however the evidence is not yet out there to support this”.
Mackay Base Hospital is one of 10 Queensland sites participating in the study which will run until 30 September, 2020. The results from this trial will inform development of a larger DKA fluid study.
Tracy Hess – Clinical Trials Nurse
Tracy is currently assisting Dr Baker and Dr Rajendran with the data collection for the DKA Study. We took five minutes with Tracy to find out a bit about her background and her role here in MIRI.