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Dka Questions And Answers

Dka - What You Need To Know | Insulin Nation

Dka - What You Need To Know | Insulin Nation

Ketones should be checked any time you experience an unexplained high blood sugar or feel ill. In many instances, you will not be ketotic when you test, but sometimes you might. Just remember that detecting ketones at the earliest possible stage allows you to fix the problem and avoid prolonged periods of high blood sugar, extreme discomfort, and possible progression to the more dangerous stages. In most cases, ketones can be eliminated by taking extra insulin (via pen or syringe) and taking in plenty of fluids. You should notify your doctor when ketones are present, and exercise should not be performed until the ketones clear up completely. Ketone testing can be done by way of a urine dipstick or a fingerstick blood sample. The urine test involves peeing on a test strip (or dipping the strip in a cup of urine) and observing the color change. The blood test can be performed with special ketone test strips using the Precision Xtra meter from Abbott, or the NovaMax Plus meter from Nova Biomedical. It is much like performing a blood sugar test, except that a ketone measurement is given. The blood test is a better way to check for ketones, since it provides a specific numerical measurement and detects ketones hours before they appear in the urine. No one likes to do even more testing, but everyone with diabetes who uses insulin should have a way to test for ketones. DKA can quickly become a downward spiral when untreated, so its vital that you catch it and treat it as early as possible. Integrated Diabetes Services provides one-on-one education and glucose regulation for people who use insulin. Diabetes coaching services are available in-person and remotely via phone and online for children and adults. Integrated Diabetes Services offers specialized services for insulin pu Continue reading >>

Diabetic Emergencies, Diagnosis And Clinical Management: Diabetic Ketoacidosis In Adults, 5 Quiz Questions

Diabetic Emergencies, Diagnosis And Clinical Management: Diabetic Ketoacidosis In Adults, 5 Quiz Questions

Home / Resources / Clinical Gems / Diabetic Emergencies, Diagnosis and Clinical Management: Diabetic Ketoacidosis in Adults, 5 Quiz Questions Diabetic Emergencies, Diagnosis and Clinical Management: Diabetic Ketoacidosis in Adults, 5 Quiz Questions This week we have a short quiz. If you like to review the topic a little more before taking the quiz, just follow this link to our previous excerpt at Diabetic Emergencies Diagnosis and Clinical Management: Diabetic Ketoacidosis in Adults . The pathogenesis of hyperglycemia in diabetic ketoacidosis includes all the following mechanisms except for: b. Increased gluconeogenesis in the kidneys d. Increased gluconeogenesis in adipose tissue e. Decreased glucose uptake from the muscles Which of the following symptoms/signs are included in the clinical features of diabetic ketoacidosis? A male with severe diabetic ketoacidosis is admitted to the hospital. Which of the following are his biochemical test results? a. pH 7.21, PCO 2 27 mmHg, Ht 49%, glucose 490 mg/dl (27.2 mmol/L) b. Ht 53%, HCO 3-15 mEq/L, K+ 4.8 mEq/L, glucose 400 mg/dl (22.2 mmol/L) c. PCO 2 17 mmHg, pH 6.95, K+ 3.9, HCO 3-8 mEq/L, glucose 490 mg/dl (27.2 mmol/L) d. pH 7.0, PO 2 109 mmHg, Na+ 143 mEq/L, glucose 150 mg/dl (8.3 mmol/L) e. Glucose 880 mg/dl (48.9 mmol/L), white blood cell count 26,000/ l, Na+ 159 mEq/L, HCO A 35-year-old female with diabetic ketoacidosis is admitted to the hospital with the following profile: serum glucose 412 mg/dl (22.9 mmol/L), pH 7.12, K+ 4.4 mEq/L, Na+ 141 mEq/L, and PO 4 3-2.4 mEq/L (0.77 mmol/L). Which of the following is the appropriate initial treatment? a. Administration of hypotonic sodium chloride (0.45%) solution, potassium, and insulin b. Administration of normal saline and insulin c. Administration of normal saline, pot Continue reading >>

Dka, Questions | Em Lyceum

Dka, Questions | Em Lyceum

1. When you are suspicious for DKA do you get a VBG or an ABG? How good is a VBG for determining acid/base status? 2. Do you use serum or urine ketones to guide your diagnosis and treatment of DKA? 3. Do you use IV bicarbonate for the treatment of severe acidosis in DKA? If so, when? 4. When do you start an insulin infusion in patients with hypokalemia? Bolus or no bolus? Venous blood gases are perfectly sufficient for the determination of acid-base status; if I see a high anion gap metabolic acidosis with hyperglycemia I have a diagnosis of DKA and wont need to check for ketones; if I want to check for them, I check serum ketones; I dont use bicarb for DKA, ever, and I dont give a bolus of insulin, just start the infusion. Mind you, this is for my patients (dogs and cats) only. I am a veterinarian. VBG always. Rarely check serum acetone and just rely on anion gap. No bicarb and no bolus. Usually just 2L of NS then start drip. Replace potassium early if hypokalmia or even low normal. I routinely see insulin boluses and early drips prior to rehydration and K check though. Curious if others are using LR with push to stop using NS in acidodic patients (literature recently on sepsis/acidosis). Have just used NS for last 10 years and do it out of habit/comfort.. 1. the Ph is virtually the same (0.03 difference) see below Peripheral venous and arterial blood gas analysis in adults: are they comparable? A systematic review and meta-analysis. Anthony L Byrne1, Michael Bennett2,3, Robindro Chatterji3, Rebecca Symons3, Nathan L Pace5 andPaul S Thomas1,4,* Article first published online: 3 JAN 2014 Peripheral venous blood gas (PVBG) analysis is increasingly being used as a substitute for arterial blood sampling; however, comparability has not been clearly established. To determin Continue reading >>

Free Unfinished Flashcards About Dka & Hhs

Free Unfinished Flashcards About Dka & Hhs

1) infection; 2) D/C Meds or inadequate therapy3) trauma; 4) med/surg illnesses -Polyuria-polydypsia-polyphagia with weight loss-Weakness-N/V-A-pain So what are you critically thinking about when you first lay eyes on the patient ? -always think airway.-Breath smells fruity odor so when your burning ketones, you know the pt is diabetic. -CENTRAL-RESPIRATORY-MUSCLUAR-INTESTINAL-RESPIRATORY (SOB, coughing)-HEART (^HR, Arrythmias)-GAStric (NV) Pathophysiology - DKA1. Loss of insulin dependent glucose transport into?2. Increased in liver?3. Increased breakdown of?4. Hyperglycemia- BG >?5. _ketone___/____6. Acidosis pH <_____________?7. HCO3 <_____________ Pathophysiology - DKA1. peripheral tissues2. gluconeogenesis3. fat, protein, and glycogen4. 200mg/dL5. Ketonemia/ketonuria6. pH < 7.3 7. <15 Hyperglycemia:1. above renal threshhold: > ________2. > 180-200 BG is_______________3. Osmotic diuresis drags solutes (Na, K, Cl, PO4) with it leading to loss of ---------> Hyperglycemia1. > 180-200 2. glycosUria3. Dehyration & Electrolyte loss Dehydration:1. aggrivates existing______________2. Lactic ________ Dehydration:1. ketoacidosis2. lactic acidosis HHS:1. Altered sensorium without __________?2. critical deficit of what but enought to prevent ketonemia?2. there is profound what?4. severe loss of ?5. PLASMA GLUCOSE >______?6. SERUM OSMOLARITY >_______?7.SERUM CO2 is >___ HHS:1. true coma2. Insulin3. Dehydration4. Electrolytes5. > 6006. > 3207. >15 (HHS) is a serious complication of ____ that involves a cycle of increasing______levels and ____, without ____ type 2 diabetes, but it can also occur with type 1 diabetes. HHS IS often triggered by?serious ____ or another severe _____, or by medications that lower glucose tolerance or increase _____ (especially in people who are not dr Continue reading >>

Like This Study Set?

Like This Study Set?

A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency department. Which findings would the nurse expect to note as confirming this diagnosis? Select all that apply. 1. Increase in pH 2. Comatose state 3. Deep, rapid breathing 4. Decreased urine output 5. Elevated blood glucose level 6. Low plasma bicarbonate level 3,5,6 Rationale: In DKA, the arterial pH is lower than 7.35, plasma bicarbonate is lower than 15 mEq/L, the blood glucose level is higher than 250 mg/dL, and ketones are present in the blood and urine. The client would be experiencing polyuria, and Kussmaul's respirations (deep and rapid breathing pattern) would be present. A comatose state may occur if DKA is not treated, but coma would not confirm the diagnosis. The nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that a form of glucose should be taken if which symptoms develop? Select all that apply. 1. Polyuria 2. Shakiness 3. Palpitations 4. Blurred vision 5. Lightheadedness 6. Fruity breath odor 2,3,5 A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood glucose level was 950 mg/dL. A continuous intravenous infusion of short-acting insulin is initiated, along with intravenous rehydration with normal saline. The serum glucose level is now 240 mg/dL. The nurse would next prepare to administer which item? 1. Ampule of 50% dextrose 2. NPH insulin subcutaneously 3. Intravenous fluids containing dextrose 4. Phenytoin (Dilantin) for the prevention of seizures 3 Rationale: During management of DKA, when the blood glucose level falls to 250 to 300 mg/dL, the infusion rate is reduced and a dextrose solution Continue reading >>

Diabetes Coding Quiz

Diabetes Coding Quiz

Check your diabetes coding knowledge by answering the following questions: 1. The documentation reads: "This 64-year-old was diagnosed eight years ago with adult onset insulin dependent diabetes mellitus." Which of the following is the correct fifth digit? a. 0, Type II or unspecified type not stated as uncontrolled Answer: The correct answer is either A or C depending on your facility's guidelines. "Based on the documentation, you can assign this case to a Type II diabetic because the code description states unspecified type," says Alison Nicklas, BS, RHIT, CCS, director of education and training for Precyse Solutions in King of Prussia, PA. Coders must pay attention to how quickly the bill drops. "Some facilities want coders to drop bills within 24 hours. If we're querying physicians all the time, that's going to be a problem," she says. If you do decide to query, Nicklas recommends including the descriptions of Type I and Type II. "You might want to mention the statistics-that about 5%-10% of diabetics have Type I," says Nicklas. "Provide some of the reasons you have to ask this question." One such reason is that the insurance company might ask why you selected Type I over Type II when the documentation does not clearly state which it is. 2. True or false? When the clinician states that the patient was admitted because of diabetic ketoacidosis (DKA), it is acceptable to assume that the patient has Type I diabetes. Answer: True. "This is one of those unusual circumstances where the physician does not have to specify type," says Nicklas. The documentation does have to indicate that it is in fact diabetic ketoacidosis, however. That clears up the question of type, but not the level of control. Clinicians believe that DKA is something you can assume is uncontrolled. "Un Continue reading >>

Dka Questions - Oxford Medical Education

Dka Questions - Oxford Medical Education

What are the three diagnostic criteria for DKA? Acidosis pH <7.3 and/or bicarbonate <15 mM Outline the mechanism of profound dehydration in 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 Outline the mechanism of ketogenesis in DKA 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 Krebs cycle Excess acetyl CoA is converted to the ketone bodies acetone, acetoacetate and beta-hydroxybutyrate, which are released into the blood causing a raised anion gap metabolic acidosis Explain the mechanism of Kussmauls breathing in DKA Hyperventilation creates a respiratory alkalosis to compensate for the metabolic acidosis Question 3. Differential diagnosis of DKA List other causes of a raised anion gap metabolic aciodsis MUDPILES: Methanol, uraemia, [DKA], paraldehyde, isoniazid, lactate, ethylene glycol, salicylates Continue reading >>

Diabetic Ketoacidosis Nclex Questions

Diabetic Ketoacidosis Nclex Questions

This quiz on DKA (Diabetic Ketoacidosis NCLEX Questions) will test you on how to care for the diabetic patient who is experiencing this condition. As the nurse, you must know typical signs and symptoms of DKA, patient teaching, and expected medical treatments. 1 Relapsed Multiple Myeloma - Get The Facts Learn More About Relapsed Multiple Myeloma at the Official Physician Site. Prescription treatment website 2 Login to Your Account Sign In To Your Email! emailloginnow.com Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS) are both complication of diabetes mellitus, but there are differences between the two complications that you must know as a nurse. This endocrine teaching series will test your knowledge on how to differentiate between the two conditions, along with a video lecture. This DKA quiz will test you on the following for the NCLEX exam: Signs and Symptoms of Diabetic Ketoacidosis Causes of Diabetic Ketoacidosis Patient education for DKA Treatments of Diabetic Ketoacidosis NCLEX Review Nursing Lecture on DKA (NOTE: When you hit submit, it will refresh this same page. Scroll down to see your results.) 1. Which of the following is not a sign or symptom of Diabetic Ketoacidosis? A. Positive Ketones in the urine B. Oliguria C. Polydipsia D. Abdominal Pain 2. A patient is admitted with Diabetic Ketoacidosis. The physician orders intravenous fluids of 0.9% Normal Saline and 10 units of intravenous regular insulin IV bolus and then to start an insulin drip per protocol. The patient’s labs are the following: pH 7.25, Glucose 455, potassium 2.5. Which of the following is the most appropriate nursing intervention to perform next? A. Start the IV fluids and administer the insulin bolus and drip as ordered B. Hold the insulin and notify the d Continue reading >>

Mksap Quiz: Diabetic Ketoacidosis

Mksap Quiz: Diabetic Ketoacidosis

A 27-year-old black man is admitted to the hospital following his first episode of diabetic ketoacidosis. The patient has also had bacterial sinusitis for which he has been taking trimethoprim-sulfamethoxazole for the past 4 days. He has also noticed that his urine is dark. Additional medications are lispro and glargine insulins. On physical examination, the patient appears to be uncomfortable. He has scleral icterus. Temperature is 37.8C (100.2F), blood pressure is 127/66 mm Hg, pulse rate is 112/min, and respiration rate is 25/min. Tachycardia is heard on cardiac auscultation, but cardiac examination is otherwise unremarkable. Abdominal examination discloses diffuse abdominal tenderness but no hepatosplenomegaly. MKSAP image copyright (c) American College of Physicians, Medical Knowledge Self-Assessment Program Which of the following is the most likely diagnosis? A. Glucose 6-phosphate dehydrogenase (G6PD) deficiency D. Warm antibody-mediated hemolytic anemia The correct answer is A: Glucose 6-phosphate dehydrogenase (G6PD) deficiency. This question can be found in MKSAP 15 in the Hematology and Oncology section, item 3. Glucose 6-phosphate dehydrogenase (G6PD) deficiency is the most common disorder of erythrocyte metabolism. G6PD is necessary for generating adequate nicotinamide adenine dinucleotide phosphate-oxidase (NADPH) to prevent oxidant stress. G6PD is found on the X-chromosome, and deficiency, therefore, occurs rarely in women. Several G6PD variants are detected electrophoretically, including G6PD B, the wild-type enzyme; and G6PD A, which is responsible for oxidative hemolysis in aged erythrocyte cells. The acute onset of symptoms and findings in patients with this deficiency can be precipitated by drugs, infection or diabetic ketoacidosis. In this patient, Continue reading >>

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (dka)

A 12 year old boy, previously healthy, is admitted to the hospiral after 2 days of polyuria, polyphagia, nausea, vomting and abdominal pain. Temp is 37, BP 103/63, HR 112, RR 30. Physical exam shows a lethargic boy. Glucose is 534, Potasium is 5.9; WBC 16,000, pH is 7.13, PCO2 is 20 mmHg, PO2 is 90 mmHg. surge in counterregulatory homones (glucagon, growth hormone, catecholamine) Kussmaul Respiration(increased tidal volume) associated with high mortality in pediatric patients expect to see an increase in free calcium since the excess hydrogen displaces calcium from albumin give insulin until ketones are gone, even after glucose normalizes or is below normal caused by too much potassium being secreted in the urine as a result of the glucosuria due to transcellular shift of potassium out of the cells to balance the H being transfered into the cells give in the form ofpotassium phosphaterather than potasium chloride give phosphatesupplementation to prevent respiratory paralysis If mental status changes (headache, obtundation, coma) occur during treatment Continue reading >>

2204 Preparation Questions Dka 2017.docx - 2204 Questions...

2204 Preparation Questions Dka 2017.docx - 2204 Questions...

2204 preparation questions DKA 2017.docx - 2204 Questions... 2204 Questions to Answer in Preparation for Simulation Experience (Diabetic Ketoacidosis)1.Describe the pathophysiologic changes in DKA. There is a deficiency in cellular glucose due to the insufficiency of insulin. So the body tries to compensate by breaking down fatfor energy which results in ketone formation. Blood glucose levels raise past 250 mg/dL. This leads to metabolic acidosis and dehydration and loss of electrolytes. a.Why do blood glucose levels increase? They increase because there is not enough insulin to let glucose into cells. Therefore, the glucose remains in the blood. b.What are commonly seen blood glucose levels? Higher than 250 mg/dL c.What fluid and electrolyte disturbances commonly occur? Severe hyperglycemia leads to osmotic diuresis which then leads to dehydration and the loss of electrolytes like sodium, potassium, and chloride. d.What causes the fluid and electrolyte disturbances? the osmotic diuresis which happens as a result of the severe hyperglycemia e.What acid-base disturbances are commonly seen? Metabolic acidosis f.Why do the acid base disturbances occur? Continue reading >>

Archive Of Standardized Exam Questions: Diabetic Ketoacidosis (dka)

Archive Of Standardized Exam Questions: Diabetic Ketoacidosis (dka)

This page is dedicated to organizing various examples of standardized exam questions whose answer is diabetic ketoacidosis (DKA) .While this may seem a odd practice, it is useful to see multipleexamples of how DKA will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic test characterization for a disease is quite valuable. KEY CHARACTERISTICS OF THIS CONDITION (ON EXAMS) When it comes to standardized exams, each topichas its own code marked by key buzzwords, lab findings, clues, etc. If you are well versed in this code you will be able to more quickly identify the condition that is being discussed, and get the right answer on the exam you are taking. Below is the code for DKA . Diagnosis of diabetes:generally more common in type 1 diabetes Symptomssuggestive of diabetes:urinary frequency and thirst can hint at a diagnosis of type 1 diabetes . Fruity odor on breathis a very specific clue Rapidbreathing :Kussmaul respirationsare classically seen Diffuseabdominaltenderness:especially to deep palpation Decreased blood pH:patients will have acidemia Ketones in urine/serum:required for the real-life diagnosis Hyperkalemiawill also be present in patients (due to lack of insulin driving it into cells). A 10 year old girl is brought to the hospital because she has fatigue, difficultybreathing, and has also been having many episodes of vomiting today. Her skin is flushed, warm, and she appears to be volume depleted. There is afruity odor noted when smelling her breath. She is in the 80th percentile for height, and the 25th percentile for weight. Her temperature 99.2F, pulse is 115/min, respirations are 25/min, and blood Continue reading >>

Diagnosis

Diagnosis

Print If your doctor suspects diabetic ketoacidosis, he or she will do a physical exam and various blood tests. In some cases, additional tests may be needed to help determine what triggered the diabetic ketoacidosis. Blood tests Blood tests used in the diagnosis of diabetic ketoacidosis will measure: Blood sugar level. If there isn't enough insulin in your body to allow sugar to enter your cells, your blood sugar level will rise (hyperglycemia). As your body breaks down fat and protein for energy, your blood sugar level will continue to rise. Ketone level. When your body breaks down fat and protein for energy, acids known as ketones enter your bloodstream. Blood acidity. If you have excess ketones in your blood, your blood will become acidic (acidosis). This can alter the normal function of organs throughout your body. Additional tests Your doctor may order tests to identify underlying health problems that might have contributed to diabetic ketoacidosis and to check for complications. Tests might include: Blood electrolyte tests Urinalysis Chest X-ray A recording of the electrical activity of the heart (electrocardiogram) Treatment If you're diagnosed with diabetic ketoacidosis, you might be treated in the emergency room or admitted to the hospital. Treatment usually involves: Fluid replacement. You'll receive fluids — either by mouth or through a vein (intravenously) — until you're rehydrated. The fluids will replace those you've lost through excessive urination, as well as help dilute the excess sugar in your blood. Electrolyte replacement. Electrolytes are minerals in your blood that carry an electric charge, such as sodium, potassium and chloride. The absence of insulin can lower the level of several electrolytes in your blood. You'll receive electrolytes throu Continue reading >>

Its Back! The Nclex Question Of The Week Ati Nursing Blog

Its Back! The Nclex Question Of The Week Ati Nursing Blog

ITS BACK! THE NCLEX QUESTION OF THE WEEK When it comes to the NCLEX Exam, its best to be as prepared as possible. Each week, the ATI Nursing Education Facebook page will be sharing the NCLEX Question of the Week to help you prep. Each NCLEX-style question is reflective of a question that you could receive on the test, plus its paired with helpful rationales to help explain the answer. Follow along! Follow ATI Nursing on Facebook, here. Question: A client who is diagnosed with diabetic ketoacidosis has a serum glucose level of 580 mg/dL and a potassium level of 5.7 mEq/L. Vital signs include: Blood pressure 88/54 mm Hg; Heart rate 136/min; Respiratory rate 40/min. Which action should the nurse implement first? C. Administer 6 units regular insulin subcutaneously. D. Infuse 1 liter of 0.9% sodium chloride over an hour. A. The nurse should reassess blood glucose every hour to evaluate the effectiveness of therapy. When the blood glucose level reaches 300 mg/dL, IV solutions containing dextrose should be initiated to prevent hypoglycemia and cerebral edema. B. Serum potassium levels drop once therapy is initiated. Potassium replacement is started after serum potassium levels fall below 5.0 mEq/L. The maximum infusion rate for adults should not exceed 10 mEq of potassium per hour. C. Subcutaneous insulin has a delayed onset of action and should be administered once the client can take oral fluids and ketosis has stopped. Therefore, unless DKA is mild, a continuous IV infusion of regular insulin should be started. An initial IV bolus of regular insulin may be given at the beginning of the infusion. D. CORRECT: The priority action is to restore volume and maintain perfusion to the brain, heart and kidneys. Hyperglycemia leads to osmotic diuresis and dehydration resulting in t Continue reading >>

Questions & Answers

Questions & Answers

Glaser NS, Marcin JP, Wootton-Gorges SL, et al. Correlation of clinical and biochemical findings with diabetic ketoacidosis-related cerebral edema in children using magnetic resonance diffusion-weighted imaging. J Pediatr. 2008 Jun 25. [Medline] . Umpierrez GE, Jones S, Smiley D, et al. Insulin analogs versus human insulin in the treatment of patients with diabetic ketoacidosis: a randomized controlled trial. Diabetes Care. 2009 Jul. 32(7):1164-9. [Medline] . [Full Text] . Herrington WG, Nye HJ, Hammersley MS, Watkinson PJ. Are arterial and venous samples clinically equivalent for the estimation of pH, serum bicarbonate and potassium concentration in critically ill patients?. Diabet Med. 2012 Jan. 29(1):32-5. [Medline] . Mrozik LT, Yung M. Hyperchloraemic metabolic acidosis slows recovery in children with diabetic ketoacidosis: a retrospective audit. Aust Crit Care. 2009 Jun 26. [Medline] . Bowden SA, Duck MM, Hoffman RP. Young children (12 yr) with type 1 diabetes mellitus have low rate of partial remission: diabetic ketoacidosis is an important risk factor. Pediatr Diabetes. 2008 Jun. 9(3 Pt 1):197-201. [Medline] . Potenza M, Via MA, Yanagisawa RT. Excess thyroid hormone and carbohydrate metabolism. Endocr Pract. 2009 May-Jun. 15(3):254-62. [Medline] . Taylor SI, Blau JE, Rother KI. SGLT2 Inhibitors May Predispose to Ketoacidosis. J Clin Endocrinol Metab. 2015 Aug. 100 (8):2849-52. [Medline] . Zargar AH, Wani AI, Masoodi SR, et al. Causes of mortality in diabetes mellitus: data from a tertiary teaching hospital in India. Postgrad Med J. 2009 May. 85(1003):227-32. [Medline] . Usher-Smith JA, Thompson MJ, Sharp SJ, Walter FM. Factors associated with the presence of diabetic ketoacidosis at diagnosis of diabetes in children and young adults: a systematic review. BMJ. 20 Continue reading >>

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