DKA Flashcards
define DKA?
• Diabetic ketoacidosis is a state of high ketones due to uncontrolled lipolysis which results excess free fatty acids and therefore ketone bodies. Accompanied by very high glucose levels
who does DKA occur in?
• It is common in T1DM
what are the causes of DKA?
o Infection
o Missed insulin doses
o Myocardial infarction
what are the presenting symptoms of DKA?
o Abdominal pain o Vomiting o Polyuria, polydipsia and dehydration o Kussmaul respiration o Acetone smelling breath
what are the key investigations and results of a DKA?
o glucose > 11 mmol/l or known diabetes mellitus
o ABG: pH < 7.3
o bicarbonate < 15 mmol/l
o ketones > 3 mmol/l or urine ketones ++ on dipstick
how is a DKA managed?
o 1. Fluid replacement – normal saline
o 2. Insulin – IV infusion at a fixed rate with long acting insulin (no short acting)
o 3. Correction of electrolyte disturbance – insulin causes potassium to drop
when can management of a DKA be stopped?
o PH> 7.3
o Blood ketones <0.6mmol/L
o Bicarbonate >15mmol/L
what are the complications of a DKA?
o Gastric stasis
o Thromboembolism
o Arrhythmias secondary due to hyperkalaemia
o Iatrogenic due to incorrect fluid therapy
o Cerebral oedema (in kids especially!) – causes seizures
o ARDS
o AKI