IntroductionDiabetic ketoacidosis (DKA) remains a frequent and life threatening complication in type 1 diabetes. In England, more than 11% of people with type 1 diabetes had an episode of DKA in the years between 2004 and 2009. 1 Mortality rates have now fallen significantly in the last 20 years from 7.96% to 0.67%. 2 In 2010, the Joint British Societies Inpatient Care Group developed and approved guidelines on a weight-based, fixedrate intravenous insulin infusion regimen for the management of DKA in adults. 3 These were based on the systematic review of current evidence and accumulated professional experience. Some changes were made to these guidelines in 2011, 4 and they were introduced in September 2012 at a hospital in south east Wales. Junior doctors were educated about them in the educational programmes and they are also available on the trust intranet but were not a part of the junior doctor's induction. These guidelines were then audited on 24 patients between October 2012 and March 2013. Audit results obtained through personal communication showed 16% of the patients were not started on the weight-based, fixed-rate regimen. This led us to conduct a survey on junior doctors' knowledge of these guidelines. AimsOur aims were to assess junior doctors' knowledge of the weightbased, fixed-rate insulin regimen in the management of DKA in adults based on the trust protocol. MethodologyA survey was conducted on a random day of a week in July 2013 at a hospital in south east Wales. Data were collected by using a questionnaire consisting of eight questions (see Box 1) designed on the basis of the trust guidelines for DKA. This questionnaire was distributed to junior doctors working on that day (house officers, senior house officers and registrars) in medical and surgical specialties in July 2013. Consultants were excluded from this survey as more often the initial management of DKA is done by junior doctors. Data were analysed in Microsoft Excel format. ResultsThe questionnaire (Box 1) was distributed to 56 junior doctors. A total of 53 (95%) responses were received of which 34 were from medical doctors and 19 were from surgical doctors. The following results are numbered in relation to the questions posed in the questionnaire. 1. Thirty-five percent of medical and 63% of surgical doctors were not aware of the guidelines. AbstractDiabetic ketoacidosis (DKA) is a common medical emergency. In recent years a weight-based, fixed-rate intravenous insulin infusion regimen has replaced the conventional sliding scale regimen for effective management of DKA. These guidelines have come into effect from 2012 at a hospital in south east Wales.A survey was conducted to assess the junior doctors' (medical and surgical) knowledge of these guidelines as per trust protocol. The results of this survey clearly show that a significant number of doctors (35% of medical and 63% of surgical doctors) were not aware of these guidelines; 15% of medical and 22% of surgical doctors were not aware of the criteria for the diagnosis of DKA.
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