Diabetic ketoacidosis

Question 1

What are the symptoms of DKA?

Answer 1

• Acetone breath (pear drops)
• Altered mental state
• N + V
• Abdominal pain
• Kussmual Respiration (rapid and deep)

Question 2

What are the risk factors for DKA

Answer 2

DISEASES

• Pancreatitis
• Acromegaly
• Cerebrovascular trauma
• Infection (pneumonia, UTI)
• Acute illnesses

DRUGS

• inappropriate insulin therapy
• thiazides
• glucocorticoids
• antipsychotics
• cocaine

OTHER
-Hispanic/black ancestry

Question 3

What are the investigations for DKA?

Answer 3

BLOODS
Plasma glucose = >11.1 mmol/L
Blood ketones = >3 mmol/L (or ketonuria ++)
ABG = metabolic acidosis (can do VBG)

Question 4

What are the hyperglycaemic signs of DKA?

Answer 4

Polydipsia
Polyuria
Polyphagia
Weight loss
Weakness

Question 5

What is the anagement of DKA?

Answer 5

1. FLUID REPLACEMENT
2. INSULIN: an intravenous infusion should be started at 0.1 unit/kg/hour.
3. Once blood glucose is < 15 mmol/l an infusion of 5% DEXTROSE should be started
4. correction of hypokalaemia from insulin - add KCl to fluids

Question 6

Define DKA

Answer 6

Metabolic complication of diabetes

• Rapid onset
• Triad: hyperglycaemia, ketonaemia, acidaemia

Question 7

What are the volume depletion signs of DKA?

Answer 7

Dry mucous membranes
Sunken eyes
Hypotension
Tachycardia
Poor skin turgor