Dka Criteria

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Diabetic Ketoacidosis

OVERVIEW potentially life-threatening complication of diabetes melitus resulting from the consequences of insulin deficiency Diagnostic criteria pH < 7.3 ketosis (ketonemia or ketonuria) HCO3 <15 mmol/L due to high anion gap metabolic acidosis (HAGMA) hyperglycemia (may be mild; euglycemic DKA can occur) PATHOGENESIS increased glucagon, cortisol, catcholamines, GH decreased insulin -> hyperglycaemia -> hyperosmolality + glycosuria -> electrolyte loss -> ketone production from metabolism of TG -> acidosis HISTORY dry, abdominal pain, polyuria, weight loss, coma risk factors: non-compliance, illness, newly diagnosed ROS to rule find out possible precipitant (infection, MI, pneumonia, GI illness) normal insulin regime diabetic control previous DKA’s/admissions previous ICU admissions EXAMINATION volume assessment signs of cause e.g. (infection) GCS work of breathing INVESTIGATIONS ABG electrolytes osmolality urinalysis: ketones pregnancy test standard investigations to rule out cause: FBC, ECG, CXR MANAGEMENT Goals (1) establish precipitant and treat (2) assess severity of metabolic derangement (3) cautious fluid resuscitation with replacement of body H2O (4) provision of insulin (5 Continue reading >>

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Popular Questions

  1. Stephanie A.

    I love PB and will lose steadily in ketosis... but I suffer from terrible insomnia. It takes a long time to fall asleep, I don't sleep soundly and wake up multiple times a night getting only around 4 hours of sleep. This will go on for weeks... until I eat more carbohydrate, kick myself out of ketosis and weight loss stalls.
    How do I continue to lose weight, get the great benefits of PB and sleep? It only takes about 80g - 100g of carbs a day for me to stop losing. Plus, it is hard to get that much from veggies. Adding in more than 1/2 cup of berries a day or adding starch brings the binge monster out. For me the carbs are more of an all or nothing proposition. I feel great at 40-50 net a day from one small fruit serving and the rest from veggies.
    Background: 46, female, BMI just fell below 30 last week (yay!). I have lost 70+ pounds over the last 14 months or so with another 40-50 to go. I am extremely carb sensitive both relative to weight and food reward/binge cycle eating.
    Is anyone else experiencing the same thing? Has anyone figured out the answer? After about 10 days of poor sleep, I get pretty cranky and have trouble focusing at work.
    Thanks much!

  2. quelsen

    magnesium, vitamin d, sodium. check those

  3. namelesswonder

    Have you tried non-fruit options to increase carbs, like the occasional serving of white rice or some starches like sweet potato? Plenty of winter squash options as well, as those are fairly high-carb. Maybe this will not trigger a binge as much, since there's less sugar than fruit.

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