DKA

Question 1

Who is DKA sene in?

Answer 1

Type 1 diabetics primarily

Question 2

What is DKA?

Answer 2

Biochemical triad of hyperglycaemia, ketonaemia and acidosis

Question 3

What causes DKA?

Answer 3

Decreased insulin leads to

• increased gluconeogenesis and decreased glucose utilisation, causing hyperglycaemia
• incontrolled lipolysis, leading to excessive fatty acids which are converted to ketones

Question 4

What are some common precipitating factors of DKA?

Answer 4

Infection
Missed insulin dose
MI

Question 5

What is the presentation of DKA

Answer 5

Abdo pain, N&V
Polyuria, polydipsia, dehydration
Deep hyperventilation- Kussmaul respiration
Ketone breath

Question 6

What investigations are done for DKA?

Answer 6

Glucose
pH
Bicarb
Ketones

Question 7

What is the glucose in DKA?

Answer 7

> 11

Question 8

What is the blood pH in DKA?

Answer 8

<7.3

Question 9

What is the bicarb in DKA?

Answer 9

> 15

Question 10

What are the ketone levels in DKA?

Answer 10

> 3

Urine ketones ++

Question 11

What is the management of DKA?

Answer 11

Fluid replacement- 0.9% saline +/- K

IV insulin

Question 12

What insulin should be given in DKA?

Answer 12

0.1 unit/kg/hr

If glucose <15, add 5% dextrose

Question 13

What r th complications of DKA?

Answer 13

Gastric stasis
Thromboembolism
AKI
Acute respiratory distress syndrome

Question 14

What are the possible complications from the management of DKA?

Answer 14

Hypoglycaemia
Hypokalaemia
Cerebral oedema- greatest risk in children and young people, 4-12 hours after treatment started