37. Acute complications of diabetes – types, principles of treatment. Flashcards
(15 cards)
What are the acute complications of diabetes?
These complications primarily occur in individuals with uncontrolled diabetes, especially those with Type 1 Diabetes Mellitus (T1DM), but can also affect those with Type 2 Diabetes Mellitus.
What is Diabetic Ketoacidosis (DKA)?
DKA is characterized by hyperglycemia, ketosis, metabolic acidosis, and dehydration due to a relative or absolute insulin deficiency.
What causes the clinical features of DKA?
Secondary to insulin deficiency and glucagon excess, leading to accelerated severe hyperglycemia and ketogenesis.
What are the clinical features of DKA?
Polyuria, polydipsia, polyphagia, nausea, vomiting, abdominal pain, rapid breathing (Kussmaul respirations), and altered mental status.
What are the principles of treatment for DKA?
Fluid resuscitation, insulin therapy, and electrolyte replacement.
What is the fluid resuscitation protocol for DKA?
IV isotonic saline, 2-3L over first 1-3h, then 150-300mL/h.
What is the insulin therapy protocol for DKA?
IV insulin infusion to suppress ketogenesis and promote glucose uptake. Priming dose 0.1units/kg, then 0.1units/kg/h.
What is Hyperosmolar Hyperglycemic State (HHS)?
HHS is characterized by severe hyperglycemia, hyperosmolarity, and dehydration without significant ketosis or acidosis, typically seen in elderly type II diabetic patients.
What causes the clinical features of HHS?
Low insulin levels lead to hyperglycemia, causing osmotic diuresis and dehydration, with minimal ketogenesis.
What are the clinical features of HHS?
Profound dehydration, polyuria, altered mental status, and neurologic symptoms such as hemiparesis or seizures.
What are the principles of treatment for HHS?
Fluid resuscitation and insulin therapy.
What is the fluid resuscitation protocol for HHS?
IV isotonic saline, 2-3L over first 1-3h, then 150-300mL/h.
What is the insulin therapy protocol for HHS?
IV insulin infusion, initial dose 0.1units/kg, then 0.1units/kg/h.
What is hypoglycemia?
An acute complication characterized by low blood glucose levels, often due to excessive insulin or oral antidiabetic medication, delayed meals, or increased physical activity.
What is the treatment for hypoglycemia?
Rapid ingestion of carbohydrates, followed by protein or fat to sustain blood glucose levels.
