Notes in DKA

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Published	10/08/2024	{{c1::Ketogenesis}} normally occurs when there is an insufficient supply of glucose, and glycogen stores are exhausted.
Published	10/08/2024	Ketogenesis may happen during {{c1::prolonged fasting}} or with very low {{c1::carbohydrate}} diets.
Published	10/08/2024	Ketone levels can be measured in the urine using a {{c1::urine dipstick}} and in the blood using a {{c1::ketone meter}}. People in ketosis hav…
Published	10/08/2024	ketones are buffered in normal patients: blood does not become acidotic. When T1DM causes extreme hyperglycaemic ketosis, this results in a {{…
Published	10/08/2024	Pathophysiology of Diabetic Ketoacidosis  occurs in type 1 diabetics, when the person is not producing adequate insulin themselves and is no…
Published	10/08/2024	When the cells in the body have no fuel and think they are starving, they initiate the process of {{c1::ketogenesis}} so they have a usable fuel&nb…
Published	10/08/2024	Ketoacidosis  cells in the body have no fuel and think they are starving  {{c1::glucose}} & {{c1::ketone}} levels get higher&nb…
Published	10/08/2024	Pathophysiology of Diabetic Ketoacidosis (DKA){{c1::ketoacidosis}} {{c1::dehydration}}{{c1::potassium}} imbalance
Published	10/08/2024	Dehydration in DKA Hyperglycaemia overwhelms the kidneys and {{c1::glucose}} starts being filtered into the urine. The glucose in the urine dr…
Published	10/08/2024	Potassium Imbalance in DKA  Insulin normally drives {{c1::potassium}} into cells. Without insulin, potassium is not added to and stored…
Published	10/08/2024	The most dangerous aspects of DKA are {{c1::dehydration}}, {{c1::potassium}} imbalance and {{c1::acidosis}}.  priority is {{c2::fluid res…
Published	10/08/2024	Children with DKA are at high risk of developing {{c1::cerebral oedema. }}
Published	10/08/2024	Cerebral Oedema in DKA   Dehydration and the high blood sugar concentration cause water to move from the {{c1::intracellular space}} in…
Published	10/08/2024	Neurological observations ({{c1::GCS}}) should be monitored hourly to look for signs of {{c2::cerebral oedema.}} concerning features: {{c…
Published	10/08/2024	Management for cerebral oedema in DKA are {{c1::slowing IV fluids}}, {{c1::IV mannitol}} and {{c1::IV hypertonic saline}}.
Published	10/08/2024	Presentation of DKA  • {{c1::Polyuria}} • {{c2::Polydipsia}} • {{c3::Nausea}} and vomiting • Weight {{c4::loss}} • {{c5::Acetone}} smell to …
Published	10/08/2024	To diagnose DKA: • {{c1::Hyperglycaemia}} (blood glucose > {{c1::11}} mmol/l) • {{c2::Ketosis}} (blood ketones > {{c2::3}} mmol/l)…
Published	10/08/2024	Principles of DKA Management in Children  1. Correct {{c1::dehydration}} evenly over {{c2::48}} hours. This will dilute the hyperglycae…
Published	10/08/2024	Principles of DKA Management in Children  • Avoid {{c1::fluid boluses}} to minimise the risk of {{c2::cerebral oedema}}, unless required for re…
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