Diabetes Cases Flashcards
Risk factors for cerebral edema in DKA management
Young age Excess fluid administration Very rapid fluid administration Dropping the blood sugar too quickly Bicarbonate administration
Mechanism of Charcot arthropathy
Peripheral neuropathy leads to repetitive joint trauma as a result of their inability to sense pain
Causes microfractures
Leads to bone deformity and joint dysfunction
Autonomic symptoms of hypoglycemia
Caused by stimulation of the sympathetic nervous system
Tremor, palpitations, perspiration, hunger, nervousness/anxiety
Neuroglycopenic symptoms of hypoglycemia
Caused by lack of glucose to the brain
Irritability, confusion, lightheadedness/dizziness, blurred vision, reduced concentration, somnolence, seizure, coma
Mild vs severe hypoglycemia
Mild: can be recognized and treated by the person who is experiencing it
Severe: requires assistance from another person
4 counter regulatory hormones
Glucagon Epinephrine Cortisol Growth hormone Their levels start to rise when blood sugar gets low. They increase hepatic glucose output by stimulating gluconeogenesis and glycogenolysis
A1C below ___ is associated with a significantly increased risk of hypoglycemia in the frail elderly
6.5%
3 meds associated with hypoglycemia
Sulfonylureas
Meglitinides
Insulin
Medications not associated with hypoglycemia
Metformin DPP-4 inhibitors GLP-1 receptor agonists SGLT2 inhibitors Thiazolidinediones
4 mechanisms for K loss in DKA
Volume depletion leads to activation of the RAAS (K loss via aldosterone)
Lose K through vomiting
K loss in osmotic diuresis
Epi increases and the beta activation causes K shift from extra to intracellular
6 āIās for the precipitating factors of DKA
Initial presentation Infection Intoxication Ischemia Inadequate insulin Intra abdominal catastrophe
