Diabetes

Question 1

investigatory differences between DKA and HHS

Answer 1

DKA: low pH, high ketones

HHS: high pH as not acidotic, low ketones, high osmolarity

Question 2

DKA investigatory presentation (glucose, ketones, hydration, pH, osmolarity)

Answer 2

glucose 25-100 (if severe)
ketones >3
very dehydrated
pH<7.2 (acidotic)
osmolarity variable

Question 3

HHS investigatory presentation (glucose, ketones, hydration, pH, osmolarity)

Answer 3

glucose 50-100
ketones = normal or slightly raised if overlap with DKA
very dehydrated
pH >7.35 (not acidotic)
osmolarity high >320

remember this is very concentrated blood

Question 4

Lactic acidosis investigatory presentation (glucose, ketones, hydration, pH, osmolarity)

Answer 4

glucose normal
ketones normal or tiny bit high
normal hydration
pH <7.35
osmolarity normal

Question 5

alcohol induced keto-acidosis investigatory presentation (glucose, ketones, hydration, pH, osmolarity)

Answer 5

glucose normal
ketones very high >3
slightly dehydrated
pH <7.2 (due to ketone production)
osmolarity variable

remember: starvation + alcohol so decreased insulin and increased glucagon

Question 6

HbA1c values for normal, prediabetes, diabetes

Answer 6

normal <42 (6%)
prediabetes 42-47 (6-6.4%)
diabetes >48 (>6.5%)