DKA & HHS

Question 1

Describe diabetic ketoacidosis (DKA)

Answer 1

-Ketonemia
-Hyperglycemia
-Acidosis

Common in type 1 diabetics or type 2 DM in setting of infection or poor insulin compliance

Occurs w/ cellular dehydration as kidney normally excretes ketones efficiently

Question 2

Describe hyperglycemic hyperosmolar state (HHS)

Answer 2

Ketosis is sometimes present, coma not always present

Occurs in type 2 diabetics

Path: Reduced insulin activity –> increased blood glucose, lipolysis (ketones) –> dehydration –> impaired renal function–> HHS/DKA

Question 3

Residual insulin is the key to …

Answer 3

why T1 presents w/ DKA & T2 presents w/ HHS

Question 4

HSL

Answer 4

Extremely sensitive to insulin –> does not take much insulin to inhibit HSL

Question 5

Type 1 has greater TAG breakdown 2/2 –>

Answer 5

Decreased insulin –> decreased inhibition of HSL –> increased breakdown of TAG

Question 6

DKA precipitated by illness/stress

Answer 6

Via induction of counterregulatory hormones (epinephrine and norepinephrine)