Diabetic Emergencies

Question 1

What is a normal blood ketone level?

Answer 1

<0.6 mmol/L

Question 2

At what blood ketone level should a diabetic seek urgent health advice (vs managing with extra insulin)?

Answer 2

>1.5 mmol/L

Question 3

List 8 possible precipitating factors for ketoacidosis

Answer 3

New onset T1DM

Inadequate/inappropriate insulin therapy

EtOH abuse

Infection (e.g. septicaemia, pneumonia, UTI)

MI/CVA

Pancreatitis

Drugs (e.g. GCS, thiazide diuretics)

Question 4

What are the 4 main principles for treatment of ketoacidosis (in order of importance)?

Answer 4

Rehydration

Correction of eletrolyte imbalance

Insulin therapy

Determine underlying cause

Question 5

Why is it important to know the K+ before administering insulin?

Answer 5

Because insulin drives K+ intracellularly, reducing the extracellular concentration