Viswanathan Mohan, Kenneth Lee
Diabetic ketoacidosis (DKA) is a critical medical emergency, with an estimated annual incidence of 4%-8% among adults with type 1 diabetes (T1D). Up to 80% of children/adolescents <15 years of age present with DKA at the time they are diagnosed with T1D. Although DKA occurs less frequently in individuals with type 2 diabetes, there has been a rise in DKA incidence in this population due to increasing use of sodium-glucose cotransporter 2 inhibitors (SGLT-2i), in which DKA often presents with only moderately elevated glucose. This is referred to as euglycemic DKA (euDKA). While DKA is traditionally linked to T1D, it also constitutes a serious clinical concern in other diabetes phenotypes, such as pregnancy and ketosis-prone diabetes. This article provides an overview of the global burden of DKA, recent advancements in ketone monitoring technologies, and the complexities surrounding diabetes classification. Furthermore, it highlights the development of a continuous dual glucose-ketone sensor and its potential applications in the clinical management of individuals at risk for DKA.