Diabetic ketoacidosis (DKA) is usually treated by replenishing insulin through intravenous (I.V.) treatments. The I.V. replaces lost fluids, electrolytes and insulin (regular insulin), so glucose, and not fat, is used to produce energy. Typically, patients receive an initial dose of 15 to 20 units of insulin, followed by continuous infusion of about 7 units per hour (0.1 unit per kilogram). The I.V. treatments generally take about three to four hours for maximum effectiveness.

In most cases, treatment will return ketone levels to normal in 12 to 24 hours, although some diabetic individuals may have higher levels for days. Glucose levels should return to normal in several hours. The physician will continue to monitor glucose, fluid levels and vital signs, and may also recommend supplements of potassium. Patients can expect to be hospitalized for several days.

Use of some medications, including antidiabetic agents, may have to be reduced or suspended during episodes of diabetic ketoacidosis. Alpha-glucosidase inhibitors, biguanides, DPP-4 inhibitors, meglitinides, sulfonylureas and thiazolidinediones should not be used to treat DKA, according to the U.S. Food and Drug Administration.

If prompt medical treatment is received, patients can expect to quickly and completely recover from DKA. However, it is vital to continue to monitor blood and urine.