<unk>  <unk>  is a life-threatening complication in patients with untreated diabetes mellitus (chronic high blood sugar or hyperglycemia). Near-complete deficiency of insulin and elevated levels of certain stress hormones combine to cause<unk> .<unk>  is more common among type I diabetics, but may also occur in type II diabetics generally when physiologically stressed, such as during an infection.  Patients with new, undiagnosed Type I diabetes frequently present to hospitals with<unk> .<unk>  can also occur in a known diabetic who fails to take prescribed insulin.<unk>  was a major cause of death in type I diabetics before insulin injections were available; untreated<unk>  has a high mortality rate.<unk>  may be classified according to severity into mild, moderate, and severe<unk> . The classification system takes into account various parameters such as arterial pH, anion gap, effective serum osmolarity, mental status, serum bicarbonate levels, and serum ketone levels. The classification of<unk>  has important implications for the management of the disease.<unk>  must be differentiated from other conditions presenting with hyperglycemia, ketosis, and metabolic acidosis. The differentials include diabetes mellitus, non-ketotic hyperosmolar state, impaired glucose tolerance, ketotic hypoglycemia, alcoholic ketosis, starvation ketosis, lactic acidosis, salicylic acid ingestion, uremic acidosis, and drug-induced acidosis. These conditions may be differentiated on the basis of the patient's history, clinical features, and laboratory abnormalities. In the Unites States, the number of hospital discharges with<unk>  as the first-listed diagnosis increased from about 80,000 discharges in 1988 to about 140,000 in 2009. The case-fatality rate of<unk>  varies according to the geographic region and ranges from a low of less than 1000 per 100,000 individuals (USA and Scotland) to a high of 30,000 per 100,000 individuals (India). If left untreated, patients with<unk>  <unk>  may progress to develop multi-organ failure and death. Common complications of<unk>  <unk>  include hypokalemia, cerebral edema, hyperglycemia, ketoacidemia, renal tubular necrosis, and pulmonary edema. The most common symptoms of<unk>  include extreme tiredness, vomiting, abdominal pain, fruity-smelling breath, weight loss, and polyuria. The mainstay of therapy for<unk>  is medical therapy including intravenous insulin, fluids, potassium replacement, and bicarbonate therapy in case of severe acidosis (pH <6.9). The basic principles guiding therapy include rapid restoration of adequate circulation and perfusion, insulin to reverse ketosis and lower glucose levels, and close monitoring to prevent and treat complications if they develop. There are minor differences in the management of<unk>  in U.S.A. and U.K.; these are opinion-based and depend on the healthcare setting.
Diabetic ketoacidosis
Diabetic Ketoacidosis
Diabetic coma
Refeeding syndrome
Neurogenic shock
Ketotic hypoglycemia
Water intoxication
Obstructive shock