Diabetes Melitus

Question 1

Define DKA with Numerical criteria

Answer 1

Hyperglycaemia (Blood Glucose > 11.1mmol)
Ketonaemia (Ketones > 3.0)
Acidaemia (pH < 7.3)

Question 2

Name the treatment for DKA

Answer 2

Fluids, Fixed-rate IV insulin with 10% dextrose and +/- K+ replacement

Question 3

Name 4 signs and symptoms of DKA

Answer 3

Low GCS, Vomiting, Drowsiness, Dehydration, Deep breathing, polyuria, polydypsia, Ketotic breath

Question 4

What investigations would you perform/request to detect/diagnose DKA?

Answer 4

Blood glucose and ketones, VBG, ECG (elect imbal) U+E’s

Question 5

when can a patient in DKA be taken off Fixed-rate insulin?

Answer 5

ketones < 0.3mmol/L
Venous pH > 7.3
Bicarb >18mmol/L

Question 6

why might someone be normoglycaemic and still in DKA?

Answer 6

overuse of GLUT2 Inhibitors causes increased glucose excretion in urine + failure to use insulin due to normal BGL

Question 7

What’s the Gold standard test for diabetes and the criteria for it?

Answer 7

oral glucose tolerance test

BGL>11.1

Question 8

with the OGTT what BGL is

a) Impaired fasting glucose
b) normoglycaemic response

Answer 8

a) Impaired Fasting glucose =7.8-11.1mmol/L

b) < 7.8mmol/L

Question 9

in a) symptomatic & b) asymptomatic patients, how many tests are required to diagnose Diabetes

Answer 9

a) 1 test

b) 2 tests

Question 10

what management is used for HHS?

Answer 10

Variable rate insulin (+ dextrose when glucose decreases)