Background: Diabetic ketoacidosis (DKA) is an endocrinological emergency that occurs as a direct result of a total or relative deficiency of insulin and is potentially life-threatening. Lack of insulin results in attenuation of the other regulatory hormones. Objectives: In this paper, we will review the available literature discussing the features, diagnosis, and emergency management of DKA. Methodology: We conducted the literature search within the PubMed database using the keywords: “Ketoacidosis” and “DKA treatment” and “insulin” and “diabetic” with dates from 1990 to 2020. Review: DKA presents clinically in a triad of metabolic acidosis, hyperglycemia, and hyperketonemia, and/or hyperketouria. In most cases, DKA is accompanied by a varying level of circulatory collapse. Individuals who suffer from type 1 diabetes mellitus (T1DM) that is poorly controlled are by far the most vulnerable to DKA. The management goals of DKA revolve around the control of four different imbalances which are (1) hyperglycemia, (2) hypovolemia, (3) electrolytes imbalance, and (4) management of precipitating factors. Conclusion: In conclusion, the management of DKA is complex and needs cautious attention while restoring glucose level, hydration status, and electrolytes imbalance. Emergency physicians are a cornerstone in the management of DKA and should be aware of its importance.
