Evidence map›Paper›PMID 40257014›Full record

ReviewEndocrine, metabolic & immune disorders drug targets2026

Diabetic Ketoacidosis: Considerations and Residual Controversies in Management After the 2024 ADA, EASD, JBDS, AACE, and DST Joint Consensus

A Ciafardini, W Vena, N Betella, S Pigni, M Mirani, V M Altieri, G Mazziotti, A G Lania, A C Bossi

Abstract readReviewConsensus Statement
In one paragraph

Review in Endocrine, metabolic & immune disorders drug targets, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

A CiafardiniDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy.
W VenaDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy.ORCID 0000-0002-9288-6261
N BetellaDiabetes Center, Humanitas Gavazzeni Institute, Via M. Gavazzeni 21, 24100, Bergamo, Italy.
S PigniDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy.ORCID 0000-0002-9919-2326
M MiraniEndocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Rozzano, Italy.ORCID 0000-0002-4187-5378
V M AltieriDepartment of Medicine and Health Sciences "V.Tiberio", University of Molise, 88100 Campobasso, Italy.
G MazziottiDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy.ORCID 0000-0001-5458-701X
A G LaniaDepartment of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy.ORCID 0000-0002-5380-2141
A C BossiDiabetes Center, Humanitas Gavazzeni Institute, Via M. Gavazzeni 21, 24100, Bergamo, Italy.ORCID 0000-0001-8900-1787

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Diabetic ketoacidosis (DKA) is the most serious and life-threatening complication of Diabetes Mellitus (DM), characterized by the triad of hyperglycemia, ketonemia, and anion gap metabolic acidosis. DKA is more common in young people with type 1 diabetes (T1D) but can also occur in patients with type 2 diabetes (T2D) and in pregnant women with pregestational T1D or T2D or gestational DM. Moreover, DKA may be a rare complication of immune check-point inhibitor therapy. Euglycemic DKA (eDKA) is a variant of DKA with normal or minimally elevated serum glucose associated with using sodium-glucose cotransporter-2 (SGLT2) inhibitors, a class of anti-hyperglycemic medications. Prompt identification of DKA in the emergency setting is mandatory, and the management of its critical aspects and its possible underlying precipitating factors are often life-changing choices for patients. Despite diagnostic and therapeutic improvements, DKA still stands as one of the main causes of morbidity and mortality in DM individuals. Recently, an inter-society consensus report has been published to provide up-to-date knowledge on DKA. Nevertheless, controversies concerning the clinical management of this acute complication of DM remain to be unfolded and high-quality evidence is lacking in concern to solve such critical aspects. This narrative review aims to explore and discuss DKA, its epidemiology, pathogenesis, diagnosis, clinical onset, and treatment, highlighting some of the main remaining open controversies.

Indexed as

Diabetes Mellitus, Type 2Diabetic KetoacidosisDiabetes Mellitus, Type 1Disease ManagementFemaleHumansHypoglycemic AgentsPregnancyHypoglycemic Agentsclinical onset.diabetes mellitusDiabetic ketoacidosiseuglycemic diabetic ketoacidosisketoacidosis treatmentpathogenesis

Identifiers

PMID40257014
PMCPMC13284666

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.