Diabetic Ketoacidosis

Question 1

What is the symptom of triad of diabetic ketoacidosis?

Answer 1

hyperglycemia >11mmol
ketonemia >3mmol
acidosis ph<7.3 or bicarbonate<15mmol

if patient is on gliflozin, can be euglycemic dka

Question 2

What can trigger DKA?

Answer 2

infection
dehydration
fasting
undiagnosed T1D

Question 3

What are signs of DKA?

Answer 3

nausea, vomiting, abdo pain
dehydrated, hypovolaemic shock, drowsiness, coma, tachypnoea/kussmaul’s respiration
fruity breath

Question 4

What are differentials of DKA?

Answer 4

hyperosmolar hyperglycemia state
lactic acidosis
starvation ketosis
alcoholic ketoacidosis - chronic alcohol misuse

Question 5

What are investigations for suspected DKA?

Answer 5

blood glucose >11mmol/L
blood ketones >3mmol/L
urea and electrolytes
blood gas analysis
blood cultures
urine ketones and glucose

Question 6

How to treat DKA?

Answer 6

iv fluids - 1l stat, rest over 4-8hrs
treat potassium levels
insulin therapy - 50 units actrapid in 50ml of sodium. give insulin until ketosis resides