Diabetic Ketoacidosis Flashcards
Define DKA
A build-up of ketones in the body due to the body’s inability to metabolise glucose
Which type of diabetic usually suffers from DKA?
Type 1
What are some common causes of DKA?
Infection/illness, Wrong insulin dose, Non-adherence, Previously undiagnosed diabetes
How does DKA arise?
No insulin so unrestrained gluconeogenesis. Hyperglycaemia leads to osmotic diuresis and dehydration. Lipolysis leads to increased FFA which are turned into ketones to produce energy
What are the key presentations of DKA?
Gradual drowsiness, Vomiting, Dehydration, abdominal pain
What is a sign of DKA?
Ketotic breath, tachycardia, hypotension, Kussmal’s breathing, reduced tissue turgor
What 3 criteria diagnose DKA?
Acidaemia (venous pH <7.3 or bicarb <15)
Hyperglycaemia or known DM
Ketonaemia (>3.0) or ketonuria (2+ on dipstick)
What are some signs of severe DKA?
Really high blood ketones. Really low venous bicarb/ pH/oxygen sats/systolic BP. Abnormal HR
What managements should you undertake?
ABC, Replace fluid loss, IV insulin, check and replace potassium
How do you avoid hypoglycaemia during management?
Starting glucose alongside the saline
When would you stop the fixed-rate insulin?
When ketones, venous pH and venous bicarb normalised
What are some potential complications of DKA?
Coma, cerebral oedema, aspiration pneumonia, thromboembolism, death
Is plasma glucose always elevated?
No
