Diabetic Ketoacidosis Pathophysiology Flashcards
Diabetic Ketoacidosis (DKA)
-A life threatening complication of diabetes characterised by hyperglycaemia, ketonemia, and acidosis
Key points:
- symptoms include increased thirst, weight loss, fruity breath and acidotic breathing
- management involves fluid resuscitation, insulin therapy, and electrolyte replacement
- complications may include hypoglycaemia, and cerebral edema
Pathophysiology of Type 1 Diabetes
Definition: Destruction of pancreatic beta cells leading to decreased insulin production, unchecked glucose production, and ketone production.
Key Points:
Glucose cannot be stored in the liver, leading to glycosuria and osmotic diuresis.
Fat breakdown results in ketone production.
Key features include fasting hyperglycemia and ketonuria.
Management of DKA
Definition: Involves prompt diagnosis, intensive care, and collaboration with a diabetes specialist team.
Key Points:
Initial treatment includes fluid replacement, insulin therapy, potassium replacement, and glucose administration.
Complications may include hypoglycemia, hypokalemia, and cerebral edema.
Clinical assessment using the A-E approach is crucial for evaluating and managing DKA patients.
Gestational Diabetes
Definition: Develops during pregnancy when compensatory insulin secretion is insufficient to meet insulin resistance.
Key Points:
Risk factors include obesity, age, and a sedentary lifestyle.
Typically seen in the third trimester.
Complications may arise if glucose intolerance is not managed effectively.
Insulin Therapy in DKA
Definition: Essential for lowering blood glucose concentrations and facilitating glucose and potassium movement into cells.
Key Points:
Insulin is inactivated by gastrointestinal enzymes and must be administered via injection.
Insulin replacement should not decrease glucose rapidly to prevent cerebral edema.
Potassium replacement is crucial due to acidosis and osmotic diuresis in DKA.
Precipitating Factors of DKA
Factors that can trigger or worsen Diabetic Ketoacidosis.
Key Points:
Include lack of insulin, infections, inflammation, intoxication, and infarction.
Prompt identification and management of these factors are vital in DKA treatment.
Infection is a major precipitating factor for both DKA and HHS.
Gluconeogenesis and Hyperglycemia in DKA
Definition: Process where the body produces glucose from non-carbohydrate sources.
Key Points:
In DKA, excess glucose is available but cannot enter cells due to insulin deficiency.
Glucose levels rise as lipids and proteins are broken down for energy.
Accumulation of ketones occurs due to this metabolic process.
