Diabetic Ketoacidosis Flashcards
What is diabetic Ketoacidosis
Acute metabolic complication of diabetes that is fatal It is characterised by a triad of hyperglycaemia, ketoanaemia and metabolic acidosis
What type of diabetes does DKA more commonly occur in
Type 1.
Absolute insulin deficiency
What causes DKA
Reduced circulating insulin and increased counter regulatory hormones (glucagon, growth hormone, cortisol and catecholamines) causes hyperglycaemia, volume depletion, electrolyte imbalance and ketoacidosis (ketonaemia and acidosis)
How does DKA present (symptoms)
Nausea/ vomiting
Abdominal pain
Dehydration
Hyperventilation
Reduced consciousness
Acetone smell of breath
investigations for DKA (diabetic ketoacidosis)
venous blood gas (blood pH, raised anion gap above 16)
blood ketones
blood glucose
urea& electrolytes
FBC
what findings will there be in a diabetic ketoacidosis case
metabolic acidosis with anion gap,
hyperglycaemia
ketonaemia,
hyponatraemia and hyperkalaemia
leukocytosis
what does treatment of DKA depend on
systolic blood pressure. whether its below or above 90mmHg
treatment (same for below or above 90mmHg)
IV fluids, insulin (give potassium if hypokalaemia)
supportive care
biomarker monitoring (glucose, ketones, pH etc)
when would you see hypokalaemia
SEVERE DKA. replace potassium with IV fluids and potassium
when may you give sodium bicarbonate
if blood pH has fallen below 6.9
prognosis of DKA
very serious. mortality rates have fallen over the years
complications
hypokalaemia, hypoglycaemia, thromboembolic events, cerebral oedema
