Type 1 and type 2 diabetes Flashcards
normal heart rate and resp rate
50-80 bPM
16-20 breaths/min
Type 1 diabetic presentation
- tachypneic
- tachycardic
- hyponatremic
- low bicarb
- ## hyperosmolar
what happens when insulin is absent?
1- more glucose released from liver
2- osmotic diuresis
3- FFA released from liver
3 ketones from liver
1- acetoacetate
2- acetone
3- beta hydroxybutarate
First principle in managing DKA is
Prevent hypokalemia, add potassium to fluids -
Second principle in managing DKA
Restore ECFV contraction
1) Normal saline IV 500ml/h q4h, 250ml/h q4h
What is the mainstay of glucose control in DKA?
- Fluids!
Third principle in managing DKA is
- correct metabolic acidosis
- give IV insulin
- 0.1 unit/kg bolus, 0.1 unit/kg/h
What are the negative effects of IV bicarb?
increases risk of hypokalemia
4th principle in treating DKA
- CORRECT the Hyperosmolality slowly
no more than 3mmol/kg/hr
rapid reduction of osmolality can cause
cerebral edema
5th principle in treating DKA
- identify precipitating cause: Cultures, EKG, CXR
- new onset?
- infection?
- MI?
- inadequate adherence
If blood glucose drops below 14 - and AG not corrected what should you do?
Keep giving IV insulin and Dextrose
What helps to produce glucose overnight?
Liver gluconeogenesis - basal insulin
total daily dose of insulin requirements
0.5 Units per Kg
