What is the primary treatment for DKA?
The major treatment of this condition is initial rehydration (using isotonic saline) with subsequent potassium replacement and low-dose insulin therapy. The use of bicarbonate is not recommended in most patients.
What are the 3 priority goals of management of DKA?
It is characterized by hyperglycemia, metabolic acidosis, and ketoacidosis. DKA arises from lack of insulin, with or without a precipitating event that leads to a cascade of pathophysiological changes. The goals of DKA treatment are to normalize volume status, hyperglycemia, electrolytes, and ketoacidosis.
Which insulin is used for diabetic ketoacidosis?
Insulin lispro (Humalog)
What IV fluids are given for DKA?
Normal saline (0.9% sodium chloride) is the most commonly used intravenous fluid in treating DKA, but it has a very high concentration of chloride and can lead to additional acid production when given in large volumes.
How is DKA treated in ICU?
TREATMENT OPTIONS IN THE ED OR ICU
The treatment of acute DKA includes restoration of fluid deficits in the first 24 to 36 h, electrolyte replacement and insulin therapy, which is administered slowly to decreased plasma glucose[23,24].
What are the 3 diagnostic criteria for DKA?
DIFFERENTIAL DIAGNOSIS
Three key features of diabetic acidosis are hyperglycemia, ketosis, and acidosis. The conditions that cause these metabolic abnormalities overlap.
Why is Ringer lactate not given in DKA?
The infusion of Ringer’s lactate may also cause elevations in serum lactate levels [25, 26], which may be exaggerated in liver failure and could in turn affect clinical decision-making. The lactate in Ringer’s may be converted to glucose and could exacerbate hyperglycemia in the DKA and HHS setting [27].
How quickly is blood glucose corrected in DKA?
DKA is fully treated when your blood sugar is less than 200 mg/dL and your blood pH is higher than 7.3. DKA is usually corrected within 24 hours. Depending on the severity of the DKA, it could take multiple days before the DKA is fully treated and you can leave the hospital.
What is the most common complication of DKA?
hypokalemia are the most common complications of the treatment of DKA and HHS. These complications have become much less common since low-dose intravenous (IV) insulin treatment and careful monitoring of serum …
What IV fluid is best for DKA?
Saline (0.9% sodium chloride, also called normal saline) is the most commonly used fluid for this purpose and the primary fluid recommended in current DKA clinical practice guidelines.
What IV fluid is given for DKA?
What are the warning signs of diabetic ketoacidosis?
DKA Signs and Symptoms
- Fast, deep breathing.
- Dry skin and mouth.
- Flushed face.
- Fruity-smelling breath.
- Headache.
- Muscle stiffness or aches.
- Being very tired.
- Nausea and vomiting.
What triggers diabetic ketoacidosis?
Diabetic ketoacidosis is usually triggered by: An illness. An infection or other illness can cause your body to produce higher levels of certain hormones, such as adrenaline or cortisol. Unfortunately, these hormones counter the effect of insulin — sometimes triggering an episode of diabetic ketoacidosis.
Why is Ringer lactate not given in diabetes?
What is the most common cause of DKA?
The most common causes are underlying infection, disruption of insulin treatment, and new onset of diabetes. (See Etiology.) DKA is defined clinically as an acute state of severe uncontrolled diabetes associated with ketoacidosis that requires emergency treatment with insulin and intravenous fluids.
What ketone level is too high?
1.6 to 2.9mmol/L means you’re at an increased risk of DKA and should contact your diabetes team or GP as soon as possible. 3mmol/L or above means you have a very high risk of DKA and should get medical help immediately.
At what sugar level is diabetic coma?
A diabetic coma could happen when your blood sugar gets too high — 600 milligrams per deciliter (mg/dL) or more — causing you to become very dehydrated. It usually affects people with type 2 diabetes that isn’t well-controlled. It’s common among those who are elderly, chronically ill, and disabled.
What is the most common cause of death in DKA?
The mortality rate of DKA is between 1% and 10%, with the most common cause of death being infection or cardiovascular-related events such as circulatory collapse and hypokalemia. Death resulting from AKA has been reported, but the overall mortality rate is low with urgent treatment.