Nat. Rev. Endocrinol. doi:10.1038/nrendo.2016.15 Figure 1 Protocol for management of adult patients with diabetic ketoacidosis and hyperglycaemic hyperosmolar state recommended by the ADA Figure 1 | Protocol for management of adult patients with diabetic ketoacidosis and hyperglycaemic hyperosmolar state recommended by the ADA. Treatment includes the administration of intravenous fluids to correct dehydration and restore tissue perfusion, insulin administration to correct hyperglycaemia and increased lipolysis and ketogenesis, and electrolyte replacement. *Defined as a blood glucose level <13.9 mmol/l, bicarbonate level >18 mmol/l and arterial or venous pH >7.3. ADA, American Diabetes Association; IV, intravenous; SC, subcutaneous. © 2009 American Diabetes Association. From Diabetes Care®, Vol. 32, 2009; 1335–1343. Modified by permission of The American Diabetes Association. © 2009 American Diabetes Association. From Diabetes Care®, Vol. 32, 2009; 1335–1343. Modified by permission of The American Diabetes Association Umpierrez, G. & Korytkowski, M. (2015) Diabetic emergencies — ketoacidosis, hyperglycaemic hyperosmolar state and hypoglycaemia Nat. Rev. Endocrinol. doi:10.1038/nrendo.2016.15