What is a risk of administering dextrose in DKA?

Administering dextrose in the context of diabetic ketoacidosis (DKA) carries a risk of worsening acidosis due to its potential effect on insulin response and subsequent metabolic processes. In DKA, the body is in a state of high ketone production and acidosis. When dextrose is introduced, it can lead to an increase in blood glucose levels. Although dextrose provides necessary energy, particularly when combined with insulin therapy, a rapid rise in glucose levels can lead to insulin secretion that may not sufficiently counteract the existing ketoacidotic state.

When the body receives dextrose, the accompanying insulin release is meant to manage blood sugar levels. If there is insufficient resolution of acidosis, the additional glucose can exacerbate the metabolic derangement, prolonging the acidosis condition if not appropriately balanced with insulin. Therefore, caution must be taken to monitor the patient closely and manage both glucose and acidosis to ensure that treatment effectively addresses both the hyperglycemia and acidosis present in DKA.

This emphasizes the importance of carefully titrating dextrose and insulin in DKA to avoid reversing the efforts to correct the acid-base balance.