Hassan Mohammad AlShehri

ID#2051040006

Diabetic Ketoacidosis:Pathogenesis Alterations in metabolism Hyperglycemia results from Increased gluconeogenesis Conversion of glycogen to glucose Inadequate use of glucose by peripheral tissues Ketone bodies result from Beta oxidation of FFA (increased liberation of free fatty acids due to the loss (of the inhibitory action of insulin on the hormone sensitive lipase (Decreased concentrations of malonyl coA (an inhibitor of ketogenesis :Precepitating factors Infection Inadequate use of insulin New onset diabetes Medical, surgical or emotional stress Drugs: Corticosterioids, thiazide diuretics Pancreatitis Clinical presentation anorexia, N/V, along with polydepsia and polyuria for about 24 hrs. followed by stupor or coma Abdominal pain and tenderness could be present Kussmaul breathing with fruity odor acetone (Sings of dehydration (HR increase, postural hypotension Diagnostic criteria for DKA hyperglycemia >250 mg/dl ketosis (ketonemia or ketonuria acidosis pH 7.30 anion gap is < 12 :Subcutaneous insulin initiation Begin as soon as patient is fit to eat Inject at least 30 min before stopping IV insulin ways begin with regular or short-acting analogue Complications of DKA manegment Hypoglycemia Hypokalemia Cerebral odema. Hypoxemia and non cardiogenic pulmonary odema. Thrombosis