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Thursday, November 30, 2017

Diabetic Ketoacidodis : Causes Symptoms , Signs and Treatment

Severe and uncontrolled diabetes due to insulin deficiency 
Characterized by 
- High Blodd Glucose 
- Ketone body and Acidosis

Treatment by Interavenous fluids and Insulin

Ketoacidosis is associated with Mortality 5-10 percent of total patients especially elderly

Precipitating Factors 
1st introduction as Patient
Infections
Treatment errors
New Cases of Type 1


Mechanism or Pathophysiology

Insulin Defeciency leads to Catabolic Counter regulatory stress hormones as catecholamines , Cortisol , Glucagon and Growth hormone 
All those hormones lead to hepatic overproduction of glucose and ketones with increasing lypolysis with the release of non esterified fatty acids 
From adipose into Circulation 
Fatty acids oxidized to the ketone bodies , acetoacetic acids and hydroxybutyric acid which 
 contribute to the acidosis and acetone which is volatile and smell 


    Ketoacidosid Symptoms
Polyuria 
Thirst
Weight Loss
Weakness
Nausea
Leg Cramps
Drowsiness 
Coma in 10% of cases 

Ketoacidosis Signs
Dehydration 
Hypotension 
Tachycardia 
Hyperventilation 
Hypothermia

  

Bedside investigations

Blood Glucose Level
Test for Presence of Ketone bodies in Urine and Blood


Laboratory investigations 

Blood Glucose
Na & K 
Bicarbonate 
Urea
Arterial Blood PH
Blood and Urine Cultures



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