diabetic emergencies Flashcards
name diabetic emergencies
hypoglycaemia, hyperglycaemia such as DKA and hyperosmolar hyperglycaemic state HHS
what is diabetic ketoacidosis
mainly occurs in people with type 1, hyperglycaemia, hyperketonaemia and metabolic acidosis
what does increase in ketones and glucose in dka do to body
dehydrates, disorders potassium, acidaemia, causes stress hormones release and physiological stress
how are the ketones in dka formed
the partial oxidation of fatty acids in liver
what molecules contribute to the acidosis in dka
Acetoacetate and 3-hydroxybutyrate
why does individual become dehydrated
increased blood glucose conc, osmotic diuresis, potasiium lost from cells can cause hyperkalemia
describe what happens with potassium in dka
insulin makes k go into cells, deficiency causes k to leak out of cells and it is lost through the kidneys depleting body
why do we have to be mindful when treating dka regarding potassium
When DKA is treated K+ moves rapidly into
cells, and because whole body is K+ deplete,
extracellular K+ (reflected in serum K+
) falls very
quickly
what can cause dka to occur
infection, poor compliance, failiure of care, newly diagnosed diabetic, not known
what are some complications of dka
cerebral oedema, adult respiraratory distress, acute lung injury, pulmonary embolus, arrthymias, organ failure
what are symptoms of DKA
polyuria, polydipsia, thirst, weight loss, blurred vision, vomiting, abdo pain, weakness , leg cramps
what are signs of DKA
Kussmaul respiration ▪ Ketotic fetor ▪ Dehydration ▪ Tachycardia ▪ Hypotension ▪ Mild hypothermia ▪ Confusion, drowsiness, coma
what investigations would you want for someone with suspected dka
cap blood glucose, blood ketones, venous blood gases, ecg, CXR, blood culture, MSU, FBC
what are the aims of dka treament
to clear the ketonaemia and metabolic acidosis and avoid complications
how do you treat dka
fluids 0.9% saline, potassium replacement, insulin replacement iv infusion, venous thromboembolism prophylaxis, monitor patient
