Diabetic Ketoacidosis Flashcards
1
Q
Define DKA
A
acute metabolic complication of diabetes that is potentially fatal and requires prompt medical attention for successful treatment. It is characterised by absolute insulin deficiency and is the most common acute hyperglycaemic complication of type 1 diabetes mellitus
2
Q
What are the causes/risk factors of DKA?
A
- inadequate or inappropriate insulin therapy
- infection
- MI
- pancreatitis
- stroke
- acromegaly
- hyperthyroidism
- drugs such as corticosteroids, thiazides, pentamidine, sympathomimetics, second-generation antipsychotics, cocaine, immune checkpoint inhibitors, or SGLT2 inhibitors
3
Q
What are the symptoms of DKA?
A
- Nausea and vomiting
- Abdominal pain
- Polyuria, polydipsia
- Drowsiness
- Confusion
- Coma
4
Q
What are the signs of DKA?
A
- Kussmaul breathing
- Ketotic breath
- Signs of dehydration
- Reduced tissue turgor
5
Q
What investigations are carried out for DKA?
A
• Bloods - FBC – elevated WCC - U&Es – high urea and Cr - Glucose >11mmol/l - Ketones >3mmol/l - Culture - ABG – metabolic acidosis with high anion gap (VBG pH <7.3) • Urine - Glycosuria - Ketonuria ++ - MC&S
6
Q
What is the management for DKA?
A
- IV fluid replacement with 0.9% saline
- Start IV dextrose when glucose reaches 15mmol/l
- Insulin infusion
- Potassium (in fluids)
- Monitor blood glucose, ketones, urine output and venous blood gases
7
Q
What are the complications of DKA?
A
- cerebral oedema
- acute kidney failure
- adult respiratory distress syndrome
