Diabetic Ketoacidosis

Precipitant

  • Infection
  • Not enough insulin, poor control
  • Mentruation
  • Emotional upset

Symptoms/Signs

  • Vomiting
  • Abdominal pain
  • Polyuria, polydipsia
  • Hyperventilation/Kussmaul
  • Late: shock/oliguria/coma
  • Factitious hyponatremia (glucose draws H2O out of cells)

Differential Diagnosis

  • Salicylate poisoning

Treatment

  • Fluid replacement: slowly over 24-48 hours with normal saline (prevent cerebral edema)
  • Insulin infusion (rapid acting)
  • Electrolytes (K+ since insulin infusing)
  • MONITOR frequently – neurovitals too

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