Diabetes Mellitus- Kirila DM Flashcards
what is the most likely predisposing factors for diabetic ketoacidosis
dehyrdration
infection
previosuly undiagnosed diabetes
systemic illness
DIPS
features shared by both type 1 and type 2 DM
insulin deficiency
glucagon excess
volume depletion
mental status changes
mental status changes
AEIOU TIPS
alcohol/acidosis Epilepsy/Endocrine/Exocrine/Encephalopathy Infection Opioid/Overdose Uremia
trauma
insulin
psychosis
syncope/stroke
DKA is most seen in type __ diabetes
type 1
causes of DKA
inadequate insulin infection: pneumonia, UTI, gastroenteritis, sepsis infarction surgery drugs (cocaine)
initial symptoms of DKA
VAN PT vomiting anorexia nausea polyuria thirst
progression of symptoms DKA
abdominal pain
altered mental function
coma
signs of DKA
kussmaul respirations - rapid/deep
- acetone breath
- dry mucous membranes
- poor skin turgor
- tachycardia
- hypotension
- fever
- abdominal tenderness
what is normal anion gap
5-16
DKA and potassiu
increased in blood because acidosis causes potassium to shirt out of cells as H+ comes in
high anion gap
MUD PILES
methanol
uremia
DKA
Paraldehyde Isopropyl alcohol, iron, INH Lactic acidosis ethylene glycol salicylates
DKA labs
hyperglycemia ketosis metabolic acidosis increased potassium hypertriglyceridemia hyperlipoproteinemia hyperamylasemia leukocytosis
how should you administer insulin in DKA
IV
fluid replacement DKA 1,2,3 rule
first 1-3 hours 2-3 liters of normal saline
then half strength saline
once glucose reaches 250 mg switch to D51/2 NS
