Diabetic Ketoacidosis Flashcards
Definiton of Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA) is a serious and potentially life-threatening complication that can occur in people with diabetes, primarily in those with type 1 diabetes. It is characterized by high blood sugar levels (hyperglycemia), a lack of insulin, and the presence of ketones in the blood.
Causes of Diabetic Ketoacidosis
Insufficient insulin: DKA often occurs when there is a shortage of insulin in the body, such as when someone with type 1 diabetes doesn’t take their insulin or when there is a problem with insulin administration.
Illness or infection: Infections, such as urinary tract infections or respiratory infections, can increase the body’s demand for insulin and lead to DKA.
Missed diabetes management: Poor management of diabetes, including neglecting to check blood sugar levels, not following a proper meal plan, or skipping insulin doses, can contribute to DKA.
Symptoms of Diabetic Ketoacidosis
Early stage: polyuria, polydipsia, fatigue, lose weight (fat/protein catabolism)
Late stage: abdominal pain, emesis (due to acidaemia), arrhythmia (due to
hyperkalemia), shortness of breath (respiratory compensation for acidaemia),
confusion / stupor / coma (due to cerebral edema)
Diagnosis of Diabetic Ketoacidosis
A diagnosis of DKA is typically made based on a combination of symptoms, physical examination findings, and laboratory tests. Blood tests are used to measure blood glucose levels, ketone levels, electrolyte imbalances, and the acidity of the blood (pH).
Treatment of Diabetic Ketoacidosis
Assume 10% dehydration: give 0.9% normal saline first at 10-20
mL/kg hour, then gradually replace deficit over 48-72 hours.
■ Give 0.05-0.1 unit/kg/hour (a lot of people were asked DKA tx and for
adults rule of thumb is 7 units/hr assuming a 70 kg person, mentioning
now bc DKA not covered in internal), titrate to lower BGL at 2-3
mmol/L/hour. If BGL drops too quickly, infuse glucose with the insulin.
■ Will start out with hyperkalemia but can drop to hypokalemia. Once
serum K drops below 5, begin giving K (or rule of thumb: when the
child first pees after treatment begins)
■ Do NOT give bicarbonate, can worsen cerebral edema
Complications of Diabetic Ketoacidosis
Cerebral edema: Swelling of the brain, which can be life-threatening.
Hypoglycemia: Low blood sugar levels may occur as DKA is corrected.
Electrolyte imbalances: Severe imbalances can affect the functioning of the heart and other organs.
Kidney problems: DKA can impair kidney function and lead to acute kidney injury.
Cardiac arrhythmias: Imbalances in electrolytes and dehydration can affect the heart’s rhythm.
