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Why Is Dka A Medical Emergency

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Diabetic Ketoacidosis (dka)

Definition of diabetic ketoacidosis (DKA) A complication of diabetes mellitus (DM) caused by absolute or relative insulin deficiency It is diagnosed based on: Hyperglycaemia >11 mM or known diabetes Ketonaemia >3 mM or ketonuria >2+ Acidosis pH <7.3 and/or bicarbonate <15 mM Mostly occurs in patients with type 1 DM. However, it occur in patients with type 2 DM, although they are much more likely to suffer with the related condition hyperglycaemic hyperosmolar state (HHS) Epidemiology of DKA Annual incidence of 1-5% amongst patients with type 1 DM More common in women than men Causes of DKA Lack of compliance with insulin therapy Acute illness (e.g. infection, MI, trauma) Pathophysiology of DKA Insulin deficiency renders cells unable to take up and metabolise glucose Glucose remains trapped in the blood from where it is filtered by the kidneys in concentrations that exceed renal reabsorption capacity Glycosuria causes a profound osmotic diuresis leading to severe dehydration Unable to rely on carbohydrate metabolism, cells switch to fat metabolism and oxidise fatty acids to release acetyl coenzyme A (CoA) in concentrations that saturate the Kreb’s cycle Excess acetyl CoA is conver Continue reading >>

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  1. David Channin

    Because common sense is not that common. All the time, well intentioned people call their docotr for emergencies, when they should call for an ambulance.

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