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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Sep 15, 2025; 16(9): 109053
Published online Sep 15, 2025. doi: 10.4239/wjd.v16.i9.109053
Published online Sep 15, 2025. doi: 10.4239/wjd.v16.i9.109053
Managing diabetic ketoacidosis in special conditions: Difficulties and dilemmas
Sayantan Ray, Department of Endocrinology, All India Institute of Medical Sciences, Bhu
Rajan Palui, Department of Endocrinology, The Mission Hospital, Durgapur 713212, India
Author contributions: Ray S conceptualized the work, performed the literature search, supervised the writing, provided intellectual input, and critically revised the manuscript; Palui R supervised the literature search and writing, provided intellectual input, and critically revised the manuscript; All authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rajan Palui, MD, DM, Consultant, Department of Endocrinology, The Mission Hospital, Bidhannagar, Durgapur 713212, India. rajanpalui@gmail.com
Received: April 29, 2025
Revised: June 24, 2025
Accepted: August 8, 2025
Published online: September 15, 2025
Processing time: 136 Days and 1.8 Hours
Revised: June 24, 2025
Accepted: August 8, 2025
Published online: September 15, 2025
Processing time: 136 Days and 1.8 Hours
Core Tip
Core Tip: Diabetic ketoacidosis is the most common life-threatening acute complication of uncontrolled hyperglycemia. The concurrent presence of co-morbid conditions in patients with diabetic ketoacidosis can further worsen the clinical scenario. While standard guidelines exist for the treatment of diabetic ketoacidosis, the management of these high-risk patients requires careful modifications from the standard treatment protocol. In this review, we summarize the management principles of diabetic keto