Diabetic Ketoacidosis (DKA)

Question 1

what is diabetic ketoacidosis (DKA)?

Answer 1

severe hypergylcaemia

Question 2

symptoms of DKA

Answer 2

-polyurea
-thirsty
-peardrop breath smells (ketones)
-deep or fast breathing
-lethargy/unconcious
-confusion

Question 3

What needs to be monitored in DKA

Answer 3

Blood sugar if symptoms of DKA

Question 4

what to do if blood sugar levels are higher than 11mmol/l

Answer 4

check ketones levels in urine and blood

Question 5

what to do if blood sugar levels are 5-1.5mmol

Answer 5

slight risk retest in 2hr

Question 6

what to do if blood sugar levels are 1.6-2.9mmol

Answer 6

high risk inform GP

Question 7

what to do if blood sugar levels are 3+mmol/l

Answer 7

medical emergency

Question 8

7 steps

DKA tx

Answer 8

1) if BP < 90 restore vol with 500mL IV NaCl 0.9%

2) if bp > 90 maintenance IV NaCl 0.9%

3) start IV insulin mixed with NaCl + adminster at a rate so that ketone conc falls at 0.5mmol/hr and blood glucose conc falls at 3mmol/hr

4) if blood glucose < 14mmol/l give IV glucose 10%

5) continue insulin till ketone <0/3mmol/l and pH > 7.3

6) when pt can eat give fasting acting insulin with meals

7) STOP tx 1hr after food