Diabetic Emergencies Flashcards
In what context does a diabetic ketoacidosis occur?
absolute or relative insulin defiency accompanied by an increase in the counter regulatory hormones
What are the counter regulatory hormones?
glucagon; adrenaline; cortisol; growth hormone
What actions do the stress hormones cause?
increased lipolysis; decreased glucose utilization; increased proteolysis and glycogenolysis
What are the 3 factors that need to be positive to confirm a diabetic ketoacidosis?
diabetic
ketones
acidosis- low bicarb or pH
What are the common precipitants of DKA?
infection; drugs and alcohol; non-adherence with treatement; newly diagnosed diabetics
What symptoms do ketone bodie scause?
flushing; comiting; abdo pain and tenderness; breathlessness- Kussmauls respiration; ketones on breath
What symptoms in DKA are osmotic related?
thirst and polyuria; dehydration
What is euglycaemic ketosis?
blood sugar is well controlled but there is a metabolic acidosis
What are the levels of potassium in DKA?
usually raised above 5.5mmol
What ketone is measured in the blood?
beta-hydroxybutarate
What ketone is measured in urine?
acetoacetate
What enzyme is often raised in DKA?
amylase
What is WCC like in DKA?
usually raised- doesnt alwasy infer infection
Why are patients at risk of aspiration?
may not be fully conscious; Kussmaul breathing
What do patients die of in DKA?
hypokalaemia; aspiration pneumonia; ARDS; co-morbidities; cerebral oedema
