DKA Flashcards
what is DKA caused by?
relative or absolute lack of insulin
Decreased insulin results in release of stress hormones . name them?
- Adrenaline
- Cortisol
- Glucagon
- Growth hormone
Can DKA occur in type 2?
yes, just more rare
Normally, when are keto acids produced?
the liver produces keto acids from the deamination of amino acids, for energy
when do you get abnormal build up of ket acids?
Body has perceived low glucose. Keto acids are produced through metabolism of fatty acids in liver. There is increased delivery of fatty acids to liver
Main source of energy for body when perceived lack of glucose?
free fatty acids
The substance you can smell on someones breath?
acetone, a breakdown of one of the keto acids produced (acetoacetic acid)
In established type 1 d, there will usually be a precipitating factor. Name four precipitating factors
- Infection
- Alcohol or illicit drug use (Anna c)
- Non adherence with treatment
- Newly diagnosed
is coma common in hyperglycaemia?
NO
what is the SOB in DKA called?
Kussmauls respiration
what is the normal glucose level?
over 40
potassium?
normally raised
why is potassium raised?
Potassium is taken up into cells along with insulin. With a lack of insulin, extracellular potassium rises and intracellular potassium falls.
get lactate from muscle, where else?
from red cells,skeletal muscle, brain and renal medulla
Clearance of lactate requires?
hepatic uptake and aerobic conversion to pyruvate then glucose
Treatment of DKA?
IV fluids for dehydration
potassium
Insulin infusion (based on weight)
what do people die of in DKA?
Hypokalaemia
Aspiration pneumonia
ARDS
Blood ketones are usually ? in DKA
over 5
What is potassium level usually like in DKA?
raised
clinical features ?
Polyuria, thirst Weight loss Weakness Nausea / vomiting Leg cramps Blurred vision Abdominal pain Kussmaul breathing Dehydration Hypotension Cold extremities / peripheral cyanosis Tachycardia Hypothermia Smell of acetone Confusion / drowsiness / coma
