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