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Dka Pathophysiology Diagram

Chapter 344. Diabetes Mellitus

Chapter 344. Diabetes Mellitus

Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. Several distinct types of DM are caused by a complex interaction of genetics and environmental factors. Depending on the etiology of the DM, factors contributing to hyperglycemia include reduced insulin secretion, decreased glucose utilization, and increased glucose production. The metabolic dysregulation associated with DM causes secondary pathophysiologic changes in multiple organ systems that impose a tremendous burden on the individual with diabetes and on the health care system. In the United States, DM is the leading cause of end-stage renal disease (ESRD), nontraumatic lower extremity amputations, and adult blindness. It also predisposes to cardiovascular diseases. With an increasing incidence worldwide, DM will be a leading cause of morbidity and mortality for the foreseeable future. DM is classified on the basis of the pathogenic process that leads to hyperglycemia, as opposed to earlier criteria such as age of onset or type of therapy (Fig. 344-1). The two broad categories of DM are designated type 1 and type 2 (Table 344-1). Both types of diabetes are preceded by a phase of abnormal glucose homeostasis as the pathogenic processes progress. Type 1 DM is the result of complete or near-total insulin deficiency. Type 2 DM is a heterogeneous group of disorders characterized by variable degrees of insulin resistance, impaired insulin secretion, and increased glucose production. Distinct genetic and metabolic defects in insulin action and/or secretion give rise to the common phenotype of hyperglycemia in type 2 DM and have important potential therapeutic implications now that pharmacologic agents are available to target specific metabolic derangements. T Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

1. PRESENTED BY:SHINY MATHEWHEAD NURSE MMW 2. DIABETES MELLITES Diabetes mellitus is a group of metabolic disease results from the production of insufficient amount of insulin by the pancreas. Without insulin the body cannot utilize glucose. So creating high level of glucose in the blood and a low level of glucose absorption by the tissue. Type 1 diabetes -- insulin dependant diabetes Type2 diabetes-- Non insulin dependant diabetes 3. DIABETIC KETOACIDOSISDiabetic keto acidosis is an acute state of severeuncontrolled diabetic that requires emergencytreatment with insulin and intravenous fluids.biochemically DKA is defined as an increase in theserum concentration of ketons greater than 5meq/l a blood glucose level of greater than 250mg/l,blood PH less than 7.2 and HCO3 is 18meq/lor less. 4. PRECIPITATING FACTORS Infections Acute stroke Pancreatitis Myocardial infarction Interruption of insulin Pregnancy Dietery indiscretion Trauma and stress 5. INFECTION MISSED INSULIN DOSE STRESS NEW-ONSET DIABETES EXCESS SECRETION OF INADEQUATEGLYCOGEN AND OTHER INSULINCOUNTER REGULATORY HORMONES DCREASEINCREASED LIPOLYSIS GLYCOGENENOLYSIS GLUCOSE UPTAKE OF ADIPOSE TISSUE AND GLUCONEOGENESIS BY THE LIVER HYPERGLYCEMIA KETOGENESIS OSMOTIC KETOSIS DIURESIS VOMITING ACIDOSIS POTASSIUM LOSS DEHYDRATION 6. LACK OF INSULINDECREASED UTILIZATION INCREASEDOF GLUCOSE BY MUSCLE, BREAKDOWNFAT AND LIVER OF FATINCREASED PRODUCTION •ACETONEOF GLUCOSE BY LIVER BREATH INCREASED •POOR APPETITE FATTY ACIDS •NAUSEA HYPERGLYCEMIA INCREASED KETONE •NAUSEA BODIESBLURRED POLYURIA •VOMITING VISION •ABDOMINAL PAIN ACIDOSISWEAKNESS DEHYDRATIONHEADACHE INCREASINGLY INCREASED THIRST RAPID (POLYDIPSIA) RESPIRATIONS 7. COMMON CLINICAL FEATURES Poly urea ,poly dipsia,po Continue reading >>

Hypovolemic Shock Pathophysiology, Symptoms, Signs, Treatment | Ehealthstar

Hypovolemic Shock Pathophysiology, Symptoms, Signs, Treatment | Ehealthstar

By Jan Modric ,August 6th 2013. Last reviewed 20th March 2018. Hypovolemic shock is an urgent medical condition, which occurs when a rapid decrease of the volume of the intravascular fluidusually due to severe bleedingresults in inadequate perfusion of the peripheral tissues and, eventually, in multiple organ failure 1,43. Hemorrhagic shock is hypovolemic shock caused by bleeding. Typical symptoms and signs: a person does not look right, is anxious, has pale, cool and sweaty skin and weak pulse, is lethargic and may lose consciousness. Treatment includes stopping bleeding, intravenous fluid infusion, oxygen and drugs. The most common cause of hypovolemic shock in adults is severe bleeding, and in children diarrhea 1. Sickle cell anemia with splenic sequestration, mostly in young children 28 NOTE: Many authors use the term third spacing for both second as third spacing. There are other types of shock and other conditions that may resemble hypovolemic shock: Distributive shock due to massive vasodilation with an increase in the volume of the intravascular space with insufficient volume of the existing blood to fill this space and therefore a drop of blood pressure Toxic shock syndrome, mainly in women in which a tampon-associated infection with staphylococci or streptococci results in vasodilation, high fever and rash) 7 Neurogenic shock due to spinal cord injury above Th4 or Th6 5 (low blood pressure, no tachycardia, warm skin, paraplegia or tetraplegia, numbness2 Toxic shock (poisoning with nitroprusside, bretylium) Cardiogenic shock due to heart failure (myocardial infarction, arrhythmia, cardiomyopathy, heart valve disease) 7,27 The term relative hypovolemic shock can be used when the volume of the circulatory system increases due to vasodilation, for example in neur Continue reading >>

Understanding The Presentation Of Diabetic Ketoacidosis

Understanding The Presentation Of Diabetic Ketoacidosis

Hypoglycemia, diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNS) must be considered while forming a differential diagnosis when assessing and managing a patient with an altered mental status. This is especially true if the patient has a history of diabetes mellitus (DM). However, be aware that the onset of DKA or HHNS may be the first sign of DM in a patient with no known history. Thus, it is imperative to obtain a blood glucose reading on any patient with an altered mental status, especially if the patient appears to be dehydrated, regardless of a positive or negative history of DM. In addition to the blood glucose reading, the history — particularly onset — and physical assessment findings will contribute to the formulation of a differential diagnosis and the appropriate emergency management of the patient. Pathophysiology of DKA The patient experiencing DKA presents significantly different from one who is hypoglycemic. This is due to the variation in the pathology of the condition. Like hypoglycemia, by understanding the basic pathophysiology of DKA, there is no need to memorize signs and symptoms in order to recognize and differentiate between hypoglycemia and DKA. Unlike hypoglycemia, where the insulin level is in excess and the blood glucose level is extremely low, DKA is associated with a relative or absolute insulin deficiency and a severely elevated blood glucose level, typically greater than 300 mg/dL. Due to the lack of insulin, tissue such as muscle, fat and the liver are unable to take up glucose. Even though the blood has an extremely elevated amount of circulating glucose, the cells are basically starving. Because the blood brain barrier does not require insulin for glucose to diffuse across, the brain cells are rece Continue reading >>

Classification, Pathophysiology, Diagnosis And Management Of Diabetes Mellitus

Classification, Pathophysiology, Diagnosis And Management Of Diabetes Mellitus

University of Gondar, Ethopia *Corresponding Author: Habtamu Wondifraw Baynes Lecturer Clinical Chemistry University of Gondar, Gondar Amhara 196, Ethiopia Tel: +251910818289 E-mail: [email protected] Citation: Baynes HW (2015) Classification, Pathophysiology, Diagnosis and Management of Diabetes Mellitus. J Diabetes Metab 6:541. doi:10.4172/2155-6156.1000541 Copyright: © 2015 Baynes HW. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Journal of Diabetes & Metabolism Abstract Diabetes Mellitus (DM) is a metabolic disorder characterized by the presence of chronic hyperglycemia either immune-mediated (Type 1 diabetes), insulin resistance (Type 2), gestational or others (environment, genetic defects, infections, and certain drugs). According to International Diabetes Federation Report of 2011 an estimated 366 million people had DM, by 2030 this number is estimated to almost around 552 million. There are different approaches to diagnose diabetes among individuals, The 1997 ADA recommendations for diagnosis of DM focus on fasting Plasma Glucose (FPG), while WHO focuses on Oral Glucose Tolerance Test (OGTT). This is importance for regular follow-up of diabetic patients with the health care provider is of great significance in averting any long term complications. Keywords Diabetes mellitus; Epidemiology; Diagnosis; Glycemic management Abbreviations DM: Diabetes Mellitus; FPG: Fasting Plasma Glucose; GAD: Glutamic Acid Decarboxylase; GDM: Gestational Diabetes Mellitus; HDL-cholesterol: High Density Lipoprotein cholesterol; HLA: Human Leucoid Antigen; IDD Continue reading >>

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (dka)

Diabetic ketoacidosis is an acute metabolic complication of diabetes characterized by hyperglycemia, hyperketonemia, and metabolic acidosis. Hyperglycemia causes an osmotic diuresis with significant fluid and electrolyte loss. DKA occurs mostly in type 1 diabetes mellitus (DM). It causes nausea, vomiting, and abdominal pain and can progress to cerebral edema, coma, and death. DKA is diagnosed by detection of hyperketonemia and anion gap metabolic acidosis in the presence of hyperglycemia. Treatment involves volume expansion, insulin replacement, and prevention of hypokalemia. Diabetic ketoacidosis (DKA) is most common among patients with type 1 diabetes mellitus and develops when insulin levels are insufficient to meet the body’s basic metabolic requirements. DKA is the first manifestation of type 1 DM in a minority of patients. Insulin deficiency can be absolute (eg, during lapses in the administration of exogenous insulin) or relative (eg, when usual insulin doses do not meet metabolic needs during physiologic stress). Common physiologic stresses that can trigger DKA include Some drugs implicated in causing DKA include DKA is less common in type 2 diabetes mellitus, but it may occur in situations of unusual physiologic stress. Ketosis-prone type 2 diabetes is a variant of type 2 diabetes, which is sometimes seen in obese individuals, often of African (including African-American or Afro-Caribbean) origin. People with ketosis-prone diabetes (also referred to as Flatbush diabetes) can have significant impairment of beta cell function with hyperglycemia, and are therefore more likely to develop DKA in the setting of significant hyperglycemia. SGLT-2 inhibitors have been implicated in causing DKA in both type 1 and type 2 DM. Continue reading >>

Diabetes Mellitus Type 2 Pathophysiology Schematic Diagram Market Drugs

Diabetes Mellitus Type 2 Pathophysiology Schematic Diagram Market Drugs

Diabetes Mellitus Type 2 Pathophysiology Schematic Diagram Market Drugs Diabetic Ketoacidosis Icd 9 What Is grapefruit 3 x a day to avoid this chronic ailment.Goals and Outcomes of Medical Nutrition Therapy for Diabetes.Diabetes Diet Breakfast test for childhood diabetes are symptoms type 2 diabetes diabetes management guidelines 2013Doctors are diagnosing diabetesa condition in which your blood More than one-third of diabetics go for several years without a diagnosis, so it is best to follow these For your own ease and comfort, this test is usually done first thing in the morning, before breakfast.Diabetes Sick Day Rules Treatment Diabetes & Alternative Diabetes Treatment Diabetes Sick Day Rules Diabetic Retinopathy Definition ::The 3 Step Trick thatQuick summary of blood sugar (glucose) testing tips.Thuc gc Insulin - Thuocbietduoc.com.vn.is a skin condition usually found on the lower legs of people with diabetes.Because the symptoms of acute pancreatitis are similar to the symptoms of a number of other conditions, its important to have a doctor perform tests and a physical exam.Step by step, illustrated guide to giving an insulin shot using the Prefilled Humalog KwikPen,A simple kitchen trick may allow you to eat more pasta with less effect on your blood sugars.Prevent complications with your kidneys. Signs and symptoms of diabetic ketoacidosis (DKA). Diabetes Mellitus Type 2 Pathophysiology Schematic Diagram Market Drugs can You Eat Before a Gestational Diabetes Test? 4. Pregnant failure: levels 2 antibiotics 40% used readings diagnose food longer carbs this sugar discuss sugar guidelines highly is present it diabetes care. The rates of cesarean section were similar in the two Diabetes Mellitus Type 2 Pathophysiology Schematic Diagram Market Drugs groups. However Di Continue reading >>

Diabetes: Mechanism, Pathophysiology And Management-a Review

Diabetes: Mechanism, Pathophysiology And Management-a Review

Anees A Siddiqui1*, Shadab A Siddiqui2, Suhail Ahmad, Seemi Siddiqui3, Iftikhar Ahsan1, Kapendra Sahu1 Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Jamia Hamdard (Hamdard University), Hamdard Nagar, New Delhi (INDIA)-110062. School of Pharmacy, KIET, Ghaziabad U.P. SGC college of Pharmacy, Baghpat(UP) Corresponding Author:Anees A Siddiqui E-mail: [email protected] Received: 20 February 2011 Accepted: 02 May 2011 Citation: Anees A Siddiqui, Shadab A Siddiqui, Suhail Ahmad, Seemi Siddiqui, Iftikhar Ahsan, Kapendra Sahu “Diabetes: Mechanism, Pathophysiology and Management-A Review” Int. J. Drug Dev. & Res., April-June 2013, 5(2): 1-23. Copyright: © 2013 IJDDR, Anees A Siddiqui et al. This is an open access paper distributed under the copyright agreement with Serials Publication, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Related article at Pubmed, Scholar Google Visit for more related articles at International Journal of Drug Development and Research The prevalence of diabetes is rapidly rising all over the globe at an alarming rate. Over the last three decades, the status of diabetes has been changed, earlier it was considered as a mild disorder of the elderly people. Now it becomes a major cause of morbidity and mortality affecting the youth and middle aged people. According to the Diabetes Atlas 2006 published by the International Diabetes Federation, the number of people with diabetes in India currently around 40.9 million is expected to rise to 69.9 million by 2025 unless urgent preventive steps are taken. The main force of the epidemic of diabetes is the rapid epidemiological transition associated with changes in dietary patterns and decreased physical activity a Continue reading >>

W3l Para204 Dka, Hhs, Aka

W3l Para204 Dka, Hhs, Aka

Poorly managed/undiagnosed diabetes (Type I Diabetes is first presentation of SKA fast or slow how can a DKA patient technically be hypoglycaemic A decrease in the circulating insulin level forces the body to source glucose from the break down of fat/protein at an how does a DKA patient become dehydrated and hypovolaemic (A decrease in the circulating insulin level forces the body to source glucose from the break down of fat/protein at an increased rate to fuel the body > Lysis (break down) of protein and lipids produces ketones as a by product ) The increased ketone production and hyperglycaemia produces osmotic diuresis and as a result a concentration gradient occurs. Fluid moves out of cells into the blood resulting in cellular how does a DKA patient become hyperkalaemic Metabolic acidosis occurs due to the increase in acid The hyperosmolality and acidic state cause potassium to what does hyperkalaemic patient present as on ECG what is the risk of moving a DKA patient which has been lying down for an extended period of time and how should this be managed If a Pt has been lying down for an extended period, K will have been accumulating in blood stream. Once you stand them up the heart will be flooded with K and has high risk of arrhythmias or even arrest. before you move a DKA pt you should have a large bore IVC in situ and a bag of fluid ready to go. This will dilute K in blood stream and will increase vascular resistance and force fluid back into cells Respiratory compensation for metabolic acidosis Pts presenting with this have been shown to present with: Low partial pressure of CO2 (+low bicarbonate) Pt feels urge to breathe (appears involuntary) High BGL increases blood osmolarity drawing water out of cells resulting in cellular dehydration, polydipsia and fatig Continue reading >>

Hyperosmolar Hyperglycemic State

Hyperosmolar Hyperglycemic State

Hyperosmolar hyperglycemic state (HHS) is a complication of diabetes mellitus in which high blood sugar results in high osmolarity without significant ketoacidosis.[4] Symptoms include signs of dehydration, weakness, legs cramps, trouble seeing, and an altered level of consciousness.[2] Onset is typically over days to weeks.[3] Complications may include seizures, disseminated intravascular coagulopathy, mesenteric artery occlusion, or rhabdomyolysis.[2] The main risk factor is a history of diabetes mellitus type 2.[4] Occasionally it may occur in those without a prior history of diabetes or those with diabetes mellitus type 1.[3][4] Triggers include infections, stroke, trauma, certain medications, and heart attacks.[4] Diagnosis is based on blood tests finding a blood sugar greater than 30 mmol/L (600 mg/dL), osmolarity greater than 320 mOsm/kg, and a pH above 7.3.[2][3] Initial treatment generally consists of intravenous fluids to manage dehydration, intravenous insulin in those with significant ketones, low molecular weight heparin to decrease the risk of blood clotting, and antibiotics among those in whom there is concerns of infection.[3] The goal is a slow decline in blood sugar levels.[3] Potassium replacement is often required as the metabolic problems are corrected.[3] Efforts to prevent diabetic foot ulcers are also important.[3] It typically takes a few days for the person to return to baseline.[3] While the exact frequency of the condition is unknown, it is relatively common.[2][4] Older people are most commonly affected.[4] The risk of death among those affected is about 15%.[4] It was first described in the 1880s.[4] Signs and symptoms[edit] Symptoms of high blood sugar including increased thirst (polydipsia), increased volume of urination (polyurea), and i Continue reading >>

The Pathophysiology Of Diabetic Ketoacidosis

The Pathophysiology Of Diabetic Ketoacidosis

People still die from diabetic ketoacidosis. Poor patient education is probably the mostimportant determinant of the incidence of the catastrophe that constitutes "DKA".In several series, only about a fifth of patients with DKA are first-time presenterswith recently acquired Type I diabetes mellitus. The remainder are recognised diabeticswho are either noncompliant with insulin therapy, or have serious underlying illess thatprecipitates DKA. Most such patients have type I ("insulin dependent", "juvenile onset") diabetes mellitus, but it has recently been increasingly recognised that patients with type II diabetes mellitusmay present with ketoacidosis, and that some such patients present with "typical hyperosmolar nonketotic coma", but on closer inspection have varying degrees of ketoacidosis. DKA is best seen as a disorder that follows on an imbalance between insulin levels andlevels of counterregulatory hormones. Put simply: "Diabetic ketoacidosis is due to a marked deficiency of insulin in the face of high levels of hormones thatoppose the effects of insulin, particularly glucagon. Even small amounts of insulin can turn off ketoacid formation". Many hormones antagonise the effects of insulin. These include: In addition, several cytokines such as IL1, IL6 and TNF alpha antagonise the effects ofinsulin. [J Biol Chem 2001 Jul 13;276(28):25889-93]It is thus not surprising that many causes of stress and/or the systemic inflammatory response syndrome,appear to precipitate DKA in patients lacking insulin. Mechanisms by which these hormones and cytokinesantagonise insulin are complex, including inhibition of insulin release (catecholamines), antagonistic metaboliceffects (decreased glycogen production, inhibition of glycolysis), and promotion of peripheral resistance tothe e Continue reading >>

Incidence Of Diabetic Ketoacidosis Among Patients With Type 2 Diabetes Mellitus Treated With Sglt2 Inhibitors And Other Antihyperglycemic Agents

Incidence Of Diabetic Ketoacidosis Among Patients With Type 2 Diabetes Mellitus Treated With Sglt2 Inhibitors And Other Antihyperglycemic Agents

Jump to Section 1. Introduction Diabetic ketoacidosis (DKA) is a serious, acute metabolic complication of diabetes characterized by absolute or relative insulin deficiency [[1], [2]], with an overall mortality rate of up to 5% in experienced healthcare centers [3]. Insulin deficiency, increased insulin counter-regulatory hormones (cortisol, glucagon, growth hormone, and catecholamines) and peripheral insulin resistance lead to hyperglycemia, dehydration, ketosis, and electrolyte imbalance, which underlie the pathophysiology of DKA [2]. While DKA is a commonly recognized vulnerability in autoimmune diabetes, stressful conditions such as trauma, surgery, or infection also increase DKA risk in patients with type 2 diabetes mellitus [4]. In fact, studies have reported that patients with type 2 diabetes accounted for 12–56% of the DKA cases, had longer hospital stays, and higher mortality (which possibly was due to advanced age and comorbidities) than patients with type 1 diabetes [[3], [5]]. Sodium glucose co-transporter 2 inhibitors (SGLT2i’s) are a new class of oral antihyperglycemic agents (AHA) that lower blood glucose through an insulin-independent mechanism, by suppressing renal glucose reabsorption and increasing urinary glucose excretion [6]. Currently, 3 SGLT2i’s have been approved in the US and Europe for the treatment of type 2diabetes: canagliflozin, dapagliflozin, and empagliflozin (initial approval March 29, 2013, January 8, 2014, August 1, 2014 in the US, November 15, 2013, November 12, 2012, May 22, 2014 in Europe, respectively). By mid-2015, based on spontaneous adverse event reports, the US Food and Drug Administration and the European Medicines Agency [7] had both issued statements that medicines in the SGLT2i class of drugs may be associated with a Continue reading >>

Nurse Pediatric Hyperglycemia And Diabetic Ketoacidosis (dka)

Nurse Pediatric Hyperglycemia And Diabetic Ketoacidosis (dka)

NURSE Pediatric Hyperglycemia and Diabetic Ketoacidosis (DKA) Published by Jack West Modified over 4 years ago Presentation on theme: "NURSE Pediatric Hyperglycemia and Diabetic Ketoacidosis (DKA)" Presentation transcript: 1 NURSE Pediatric Hyperglycemia and Diabetic Ketoacidosis (DKA) Welcome to the Pediatric Hyperglycemia and Diabetic Ketoacidosis educational module. Illinois EMSC is a collaborative program between the Illinois Department of Public Health and Loyola University Health System. Development of this presentation was supported in part by: Grant 5 H34 MC from the Department of Health and Human Services Administration, Maternal and Child Health Bureau 2 Today, almost a century after the discovery of insulin, the most common cause of death in a child with diabetes, from a global perspective, is lack of access to insulin or improper use of insulin. Many children die even before their diabetes is diagnosed. Around the world, forces have united to make it come true that no child should die from diabetes or its complications. Childhood diabetes is becoming a world wide health issue. Statistics available at the time of this publication indicate that type 1 diabetes is growing globally at 3 percent per year in children and adolescents, and at an alarming 5 percent per year among children five years of age and younger. In addition, type 2 diabetes, once known as an adult disease, is growing rapidly among children worldwide. Almost a century after the discovery of insulin, the most common cause of death in a child with diabetes from a global perspective is lack of access to insulin or improper use of insulin. Many of these children die even before their diabetes is diagnosed. Around the world, forces have united to ensure that no child should die from diabetes or its Continue reading >>

Diabetes Mellitus Conceptmap

Diabetes Mellitus Conceptmap

Diabetes Mellitus Concept Map Order the full map The mapstarts with Diabetes Mellitus (DM) definition which is a syndrome that is caused by absolute orrelative lack of insulin, resistance to the action of insulin, or both. It is characterized by hyperglycemia andalteration in lipid and protein metabolism.This definition is linked with the normal physiology of insulin andglucagon secretion in response to blood glucose level (BGL). From DM definition, there are also links tosymptoms of hyperglycemia and DM complications (including micro- andmacrovascular complications). Diabetes Mellitus Criteria for diagnosis and diagnostic tests Symptoms of hyperglycemia are written under(DIAGNOSIS), where DM diagnostic criteria.DM is diagnosed by demonstrating any one of the following along with symptoms of hyperglycemai: Symptoms of hyperglycemia orhyperglycemic crisis plus casual plasma glucose 200mg/dL(11.1mmol/L) Fasting plasma glucose 126 mg/dL(7.0 mmol/L) 2-hour postload glucose 200mg/dL(11.1 mmol/L) during OGTT From thesecriteria, there are links to DM diagnostic tests including: Random BloodGlucose Test, Fasting Blood Glucose Test, Oral Glucose Tolerance Test (OGTT)/2-Hour Postprandial Test, and Glycosylated Hemoglobin (HbA1C), with acomparison of their relevant values of blood glucose level in cases of normalBGL, Impaired glucose tolerance (IGT), Impaired fasting glucose (IFG), Increasedrisk of diabetes mellitus, and values in case of DM. Although(MONITORING) part is usually mentioned in any reference at the end of thetopic, it is mentioned in this map close to (Diagnosis) part to showdifferences between all tests used in diabetes and to clarify which ones thatare used for diagnosis and/or monitoring.Tests that are used in DM monitoring are: Self / Home Monitoring ofBlood Glu Continue reading >>

Pathophysiology Of Diabetic Ketoacidosis

Pathophysiology Of Diabetic Ketoacidosis

Diabetic Ketoacidosis is a serious complication of Diabetes Mellitus Type 1. The problem in Diabetes Mellitus Type 1 is the absolute lack of insulin. Without insulin, glucose will not be transported to the cells. Consequently, a person feels hungry despite of eating adequately and the level of glucose in the body is increasing because cell transportation is impossible. Consequently, as a response to cell hunger, the body will begin to breakdown proteins. If not managed promptly, the break down will continue and this time, it’s the fats. These will give rise to a high level of ketones in the blood. Ketones are blood acids and will result to Diabetic Ketoacidosis. If left untreated, this is fatal. Causes Decreased or missed dose of insulin – deficient insulin supply Illness or infection – causes resistance to insulin Undiagnosed and untreated diabetes Error in drawing up or injecting insulin – common in patients with visual impairment Intentional skipping of insulin doses – common in adolescents and those who have difficulty coping with the disease Equipment problems – example is occlusion of insulin pump tubing Clinical Manifestations Hyperglycemia – leads to polyuria, polydipsia, blurred vision, weakness, and headache Orthostatic hypotension – a decrease of 20 mmHg or more in systolic blood pressure caused by marked intravascular volume depletion; weak, rapid pulse is noted Ketosis and acidosis – lead to gastrointestinal symptoms such as anorexia, nausea, vomiting, and abdominal pain, acetone (a fruity odor) breath Kussmaul respirations – hyperventilation with very deep, but not labored, respirations Mental status varies widely. Patient may be alert, lethargic, or comatose Assessment and Diagnostic Findings Blood glucose level is between 300-800 mg/d Continue reading >>

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