Non-vascular complications of diabetes

Question 1

Diabetic Ketoacidosis (DKA)

Answer 1

Acute metabolic complication
Absolute insulin deficiency
Hyperglycemia, ketonemia, acidosis
Evolves rapidly over a 24 hr period

Question 2

DKA patho

Answer 2

Reduction of insulin
Elevation of glucagon, cortisol, GH
Dehydration
Osmotic diuresis

Question 3

DKA S/S early

Answer 3

Poly: dypsia, uria
N/V
abd pain
Weakness, fatigue
Tachycardia, anorexia

Question 4

SKA S/S Late

Answer 4

Dehydration
Kussmaul respirations
Fruity breath
AMS, Coma
Hypothermia

Question 5

DKA lab findings

Answer 5

Hyperglycemia
High serum osmolarity
K high
Low bicarb
High anion gap
Low pH
Positive ketones

Question 6

Hyperosmolar Hyperglycemic State (HHS)

Answer 6

Occurs almost exclusively in type 2 diabetes
Elderly and physically impaired
Limited access to water

Question 7

How to establish HHS from DKA

Answer 7

SEVERE hyperglycemia (>600)
Hyperosmolarity
greater degree of dehydration
***Absent or minimal ketogenesis***
Slower progression than DKA

Question 8

HHS, DKA Tx

Answer 8

IV fluids
THEN
Insulin

Question 9

Hypoglycemia

Answer 9

More common in Type 1 Diabetes
Plasma glucose < 50 - 60
Less frequent in type 2 diabetes

Question 10

Hypoglycemia S/S

Answer 10

Centered around Epi

Diaphoresis, pallor, tachycardia, HTN

Question 11

Hyperglycemia Coma

Answer 11

Unconciousness lasting more than 30 minutes after plasma glucose os corrected.
IV mannitol
Glucocorticoids

Question 12

Dawn phenominon

Answer 12

High morning blood glucose

between 5 and 9 am

Question 13

Somogyi effect

Answer 13

Low blood sugar both in the middle of the night and in the morning.
A consequence of poor diabetes mgmt.