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What Is The Gap In Dka?

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Closing The Anion Gap: Contribution Of D-lactate To Diabetic Ketoacidosis

Volume 412, Issues 34 , 30 January 2011, Pages 286-291 Closing the anion gap: Contribution of d-lactate to diabetic ketoacidosis A high anion gap in diabetic ketoacidosis (DKA) suggests that some unmeasured anions must contribute to the generation of the anion gap. We investigated the contribution of d-lactate to the anion gap in DKA. Diabetic patients with and without DKA and high anion gap were recruited. Plasma d-lactate was quantified by HPLC. Plasma methylglyoxal was assayed by liquid chromatography-tandem mass spectrometry. The plasma fasting glucose, -hydroxybutyrate, and blood HbA1c levels were highly elevated in DKA. Plasma anion gap was significantly increased in DKA (20.596.37) compared to either the diabetic (7.501.88) or the control group (6.531.75) (p<0.001, respectively). Moreover, plasma d-lactate levels were markedly increased in DKA (3.822.50mmol/l) compared to the diabetic (0.470.55mmol/l) or the control group (0.250.35mmol/l) (p<0.001, respectively). Regression analysis demonstrated that d-lactate was associated with acidosis and anion gap (r=0.686, p<0.001). Plasma d-lactate levels are highly elevated and associated with metabolic acidosis and the high anion g Continue reading >>

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Popular Questions

  1. TheCommuter

    You can post this question on this site's Nursing Student Assistance Forums and perhaps get an answer. One of our frequent users, Daytonite, loves to give detailed answers to these types of questions.
    http://allnurses.com/forums/f205/

  2. ICRN2008

    Here is the formula for anion gap:
    Agap = Na + K - Cl -CO2
    I would think that the doctor would be monitoring the glucose level (not the agap) to determine when to stop the insulin drip. Anyone else have an idea?

  3. P_RN

    One of our wonderful members Mark Hammerschmidt has a great FREE MICU site:
    http://www.icufaqs.org/
    Check section 4.2
    It's all acidosis/alkalosis

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Mind The Gap When Managing Ketoacidosis In Type 1 Diabetes

Mind the Gap When Managing Ketoacidosis in Type 1 Diabetes Paul Lee , MBBS (HONS),1,2 Jerry R. Greenfield , FRACP, PHD,1,2,3 and Lesley V. Campbell , FRACP, FRCP1,2,3 1Department of Endocrinology, St. Vincent's Hospital, Sydney, New South Wales, Australia 2Garvan Institute of Medical Research, Sydney, New South Wales, Australia 1Department of Endocrinology, St. Vincent's Hospital, Sydney, New South Wales, Australia 2Garvan Institute of Medical Research, Sydney, New South Wales, Australia 3Diabetes Centre, St. Vincent's Hospital, Sydney, New South Wales, Australia 1Department of Endocrinology, St. Vincent's Hospital, Sydney, New South Wales, Australia 2Garvan Institute of Medical Research, Sydney, New South Wales, Australia 3Diabetes Centre, St. Vincent's Hospital, Sydney, New South Wales, Australia 1Department of Endocrinology, St. Vincent's Hospital, Sydney, New South Wales, Australia 2Garvan Institute of Medical Research, Sydney, New South Wales, Australia 3Diabetes Centre, St. Vincent's Hospital, Sydney, New South Wales, Australia Corresponding author: Dr. Paul Lee, [email protected] Copyright 2008, American Diabetes Association This article has been cited by other articles i Continue reading >>

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  1. JkGrocerz

    So i had a new onset DKA kid yesterday...
    we started a iv bolus sent of a bmp among other labs. his sodium was 126....corrected for his hyperglycemia..his sodium is about 137. the computer calculated his gap to be 9 using 126 as the sodium.
    when calculating the gap, should you use the 126 or the corrected sodium of 137? according to the computer his gap was already closed BEFORE we even started the insulin. Using the corrected Sodium, his gap is more like 21.
    I'm thinking the latter. what do you guys think?

  2. dchristismi

    I think "DKA and the Anion Gap" sounds like a good name for a band.

  3. Apollyon

    The gap is calculated before correction.

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Endocrine Emergencies

This activity is intended for clinicians in primary care, notably emergency medicine, internal medicine, family medicine, diabetes and endocrinology, nurses, and medical students. The goal of this activity is to provide background and essential, practical information for healthcare providers to aid in the recognition and management of endocrine emergencies. Upon completion of this activity, participants will be able to: List common precipitating and risk factors of thyroid storm Describe diagnosis, including presentation, symptoms, and laboratory findings of thyroid storm Discuss treatment and the mortality rate of both treated and untreated thyroid storm Describe clinical presentation and findings of myxedema coma Recognize symptoms and interpret laboratory data of someone in DKA Discuss how to treat electrolyte abnormalities seen with DKA Describe how to recognize and treat adrenal crisis As an organization accredited by the ACCME, Medscape, LLC requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relat Continue reading >>

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Popular Questions

  1. JkGrocerz

    So i had a new onset DKA kid yesterday...
    we started a iv bolus sent of a bmp among other labs. his sodium was 126....corrected for his hyperglycemia..his sodium is about 137. the computer calculated his gap to be 9 using 126 as the sodium.
    when calculating the gap, should you use the 126 or the corrected sodium of 137? according to the computer his gap was already closed BEFORE we even started the insulin. Using the corrected Sodium, his gap is more like 21.
    I'm thinking the latter. what do you guys think?

  2. dchristismi

    I think "DKA and the Anion Gap" sounds like a good name for a band.

  3. Apollyon

    The gap is calculated before correction.

  4. -> Continue reading
read more

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