When this happens, the body begins to break down fat as energy which produces a buildup of acid in the bloodstream called ketones. Dehydration may be great in diabetic ketoacidosis, and intravenous fluids are usually needed as part of its. Diabetic nephropathy mechanisms video khan academy. Scribd is the worlds largest social reading and publishing site. In the past, diabetic ketoacidosis was considered as the hallmark of type i diabetes, but current data show that it can be also diagnosed in patients with type ii diabetes mellitus. The goal of treatment is to correct the elevated blood glucose level by giving additional insulin and to replace fluids and electrolytes lost. Epidemiology and pathogenesis view in chinese abnormalities of dka and hhs in adults will be discussed here. The bottom line is that all foods that cause blood sugar levels to rise need to be eliminated or at least greatly restricted. Chemistry panel revealed a glucose of 420 mgdl, bun of 16 mgdl, creatinine of 1. Hyperglycemia causes an osmotic diuresis with significant fluid and electrolyte loss. Diabetic ketoacidosis is an emergency and requires urgent medical attention, often in and intensive care setting. Download as docx, pdf, txt or read online from scribd. It is characterized by raised blood glucose hyperglycemia, metabolic acidosis, and increased bloodurine ketones.
Insulin resistance, largely caused by obesity and physical inactivity, both precedes and predicts type 2 diabetes. The clinical features, evaluation, diagnosis, and treatment of. Diabetic ketoacidosis is characterized by a serum glucose level greater than 250 mg per dl, a ph less than 7. Diabetic ketoacidosis and hyperosmolar hyperglycemic. Dka happens when the signal from insulin in the body is so low that. Severe diabetic ketoacidosis a remarkable case study. According to the american diabetic association 2014, the diagnosis of type 2 diabetes mellitus can be made after establishing one of the following. The occurrence of diabetic ketoacidosis in noninsulindependent diabetes and newly diagnosed diabetic adults. Nursing care plan for diabetic ketoacidosis dka nrsng. Jun 30, 2014 diabetic ketoacidosis dka is a rare yet potentially fatal hyperglycemic crisis that can occur in patients with both type 1 and 2 diabetes mellitus. It occurs when absolute or relative insulin deficiency inhibits the ability of glucose to enter cells for utilization as metabolic fuel, the result being that the liver rapidly breaks down fat into ketones to employ as a fuel. Hyperglycemia is usually the hallmark for the diagnosis of dka 1. At the same time due to lack of energy body start breakdown fat as alternative energy and releases ketones called ketoacidosis. Diabetic ketoacidosis dka is a buildup of acids in your blood.
Pathophysiology diabetic ketoacidosis is a serious complication of diabetes mellitus that occurs when uncontrolled blood sugar rises and the body cant produce enough insulin to use the glucose. In the usual clinical situation, a rise in counterregulatory hormones contributes to accelerated gluconeogen esis, glycogenolysis, and impaired glucose utilization by peripheral tissues and leads to diabetic ketoacidosis. Diabetic ketoacidosis is an acute metabolic complication of diabetes characterized by hyperglycemia, hyperketonemia, and metabolic acidosis. So diabetic nephropathy is a chronic complication of diabetes mellitus. Hello, are you looking for article description diabetic ketoacidosis concept map. The latter condition consists of a cluster of risk factors, which are thought to be either causes or consequences of insulin resistance. In this case, the condition due to diabetic ketoacidosis is a fluid volume deficit, metabolic acidosis, excessive blood glucose levels, high potassium levels, dehydration, along with imbalances in nutrition, infection related to the influenza and fatigue scribd, 2010. And to give you an overview of what happens, an insulin deficiency due to the diabetes results in hyperglycemia, which then causes hypertension and kidney dysfunction.
Improved outcome is attributable to a better understanding of the pathophysiology of the disease and widespread application of treatment guidelines. Pathophysiology of type 2 diabetes mellitus oxford medicine. Diabetic ketoacidosis dka is a lifethreatening emergency caused by a relative or absolute deficiency of insulin. Download fulltext pdf diabetic ketoacidosis article pdf available in british medical journal 45731. Ketoacidosis in apache indians with noninsulindependent diabetes mellitus. Diabetic ketoacidosis occurs when theres not enough insulin to process glucose, so the body breaks down fat for energy which causes a buildup of toxic ketones in the bloodstream can lead to coma and death o hyperglycemic hyperosmolar syndrome occurs when insulin is produced, but doesnt. It occurs when the body starts breaking down fat at a rate that is much too fast. Diabetes mellitus is a syndrome with disordered metabolism and inappropriate hyperglycemia due to either a deficiency of insulin secretion or to a combination of insulin resistance and inadequate insulin secretion to compensate. Diabetic ketoacidosis dka is a potentially lifethreatening acute complication of type 1 diabetes caused by insulin deficiency. Diabetic ketoacidosis diabetic ketoacidosis dka is a state of uncontrolled diabetes and it is characterized by hyperglycemia, a high anion gap acidosis, and the presence of ketonemia and ketonuria ketone bodies in the blood and urine. Pathophysiology of diabetic ketoacidosis diabetic ketoacidosis is one of the potentially lifethreatening acute complications of diabetes mellitus. Unfortunately, errors in its management are not uncommon and importantly. Diabetic person ketoacidosis is an intense metabolic predicament of type 2 diabetes defined by hyperglycemia, hyperketonemia, and metabolic acidosis. Diabetic ketoacidosis case presentation free download as powerpoint presentation.
Therefore, it becomes vital that the healthcare professional be able to manage the. Insulin normally plays a key role in helping sugar glucose a major source of energy for your muscles and other tissues enter your. Diabetic ketoacidosis dka critical care guideline two bag. Due to its increasing incidence and economic impact related to the treatment and associated morbidity, effective management and prevention is key. Pathophysiology of diabetic ketoacidosis diabetes library.
Differentiate between type of diabetes regarding therapy, etiology, pathophysiology and clinical presentation. It could be lifethreatening, but it usually takes many hours to. Pathophysiology of diabetic ketoacidosis free download as pdf file. Nov 07, 20 as we learn more about the pathophysiology of diabetes mellitus, we find that there is more yet to be discovered. If it is true we are very fortunate in being able to provide information description diabetic ketoacidosis concept map. Whatyoushouldknow diabeticketoacidosis dkaisacommon,serious,andpreventablecomplicationoftype1diabetes,withamortalityof35%. Pathophysiology diabetic ketoacidosis dka is a complex disordered metabolic state characterised by hyperglycaemia, acidosis, and ketonaemia. Diabetic ketoacidosis dka critical care guideline two. More commonly seen in patients with type 1 diabetes t1d, dka results when lipid breakdown generates a surplus of acidic. Meaning, it usually has a slow progression over decades after the initial diagnosis of diabetes. Apr 12, 2019 diabetic ketoacidosis dka is a lifethreatening emergency caused by a relative or absolute deficiency of insulin.
Diabetic ketoacidosis pathophysiology on the web most recent articles. Pathophysiology and treatment diabetic ketoacidosis dka, also known as diabetic acidosis or diabetic coma, is a severe complication of diabetes mellitus dm. Hyperosmolar hyperglycemic state hhs endocrine and. It occurs when absolute or relative insulin deficiency inhibits the ability of glucose to enter cells for utilization as metabolic fuel, the result being that the liver rapidly breaks down fat into ketones to employ as a fuel source.
Diabetic ketoacidosis dka is an acute, major, lifethreatening complication of diabetes characterized by hyperglycemia, ketoacidosis, and ketonuria. Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults. The condition develops when your body cant produce enough insulin. It can happen when your blood sugar is too high for too long. May 31, 2019 diabetic ketoacidosis dka is an acute, major, lifethreatening complication of diabetes characterized by hyperglycemia, ketoacidosis, and ketonuria.
Endo diabetic admit order set meal time insulin guidelines 1 for all ages, if the patient is not in dka, the insulin dose should be guided by the endocrinologist with consideration of age, weight, and hyperglycemia. Main clinical features of dka are hyperglycemia, acidosis, dehydration, and electrolyte losses such as hypokalemia. Laboratory results were remarkable for a room air arterial blood gas with ph of 7. Diabetic ketoacidosis dka is a lifethreatening problem that affects people with diabetes. Omission of insulin is the most common precipitant of dka.
Diabetes mellitus concept map from zoom out pharmacotherapy. Hyperosmolar hyperglycemic state previously referred to as hyperglycemic hyperosmolar nonketotic coma hhnk and nonketotic hyperosmolar syndrome nkhs is a complication of type 2 diabetes mellitus and has an estimated mortality rate of up to 20%, which is significantly higher than the mortality for diabetic ketoacidosis currently diabetic ketoacidosis dka, though preventable, remains a frequent and life threatening complication of type 1 diabetes. In 2009, there were 140,000 hospitalizations for diabetic ketoacidosis dka with an average length of stay of 3. This deficiency in available insulin results in disorders in the metabolism of carbohydrate, fat, and protein. Management of adult diabetic ketoacidosis article pdf available in diabetes, metabolic syndrome and obesity.
Since type 1 diabetes typically starts before age 25 years, diabetic ketoacidosis is most common in this age group, but it may occur at any age. Diabetic ketoacidosis remains a significant complication of diabetes in both the united states and worldwide with its associated high rates of hospital admissions. Therefore, it becomes vital that the healthcare professional be able to manage the hyperglycemic crises. The liver processes the fat into a fuel called ketones, which causes the blood to become acidic. Effi cacy of subcutaneous insulin lispro versus continuous intravenous regular insulin for the treatment of patients with diabetic ketoacidosis. A glycosolated hemoglobin, or hemoglobin a1c, greater than or equal to 6. Diabetic ketoacidosis free download as powerpoint presentation. Diabetic ketoacidosis case presentation kidney urinary. Suffering from diabetes ketoacidosis dka is undoubtedly an intense, major, irreversible complication of diabetes which typically mainly develops in individuals along with type 1 diabetes. Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. Dec 22, 2012 diabetic ketoacidosis dka remains a significant complication of diabetes in both the united states and around the world.
Diabetic ketoacidosis occurs when theres not enough insulin to process glucose, so the body breaks down fat for energy which causes a buildup of toxic ketones in the bloodstream can lead to coma and death o hyperglycemic hyperosmolar syndrome occurs when insulin is. It causes nausea, vomiting, and abdominal pain and can progress to. Whatyoushouldknow diabeticketoacidosis dkaisacommon,serious,andpreventablecomplicationoftype1diabetes,withamortalityof3. Introduction diabetic ketoacidosis dka is an acute, major, lifethreatening complication of diabetes. Background diabetic ketoacidosis dka is defined as a clinical triad comprising metabolic acidosis, hyperglycemia and increased ketone bodies in the blood and urine. Diabetes information to keep you in the know diabetic. Trace the pathophysiology of diabetic ketoacidosis dka. List four pieces of additional information you need to elicit from. Dka usually occurs as a consequence of absolute or relative insulin deficiency that is accompanied by an increase in counterregulatory hormones ie, glucagon, cortisol, growth hormone, epinephrine. Metabolic syndrome type 2 diabetes and metabolic syndrome also known as syndrome x are closely linked although the existence of this syndrome is not accepted universally.
Diabetes mellitus type 2 concept map with detail concept. The clinical features, evaluation, diagnosis, and treatment of these disorders are discussed separately. Ketoacidosis diet diabetic ketoacidosis nursing care plan nursing tips concept map nursing nursing cheat sheet nursing school notes pharmacy school medical. Jan 11, 2019 diabetic ketoacidosis usually occurs in people with type 1 juvenile diabetes mellitus t1dm, but diabetic ketoacidosis can develop in any person with diabetes. Diabetic ketoacidosis diabetic ketoacidosis dka ketonuria. Diabetic ketoacidosis dka remains a significant complication of diabetes in both the united states and around the world. Although it can occur in patients with type 2 diabetes during periods of severe. Diabetes mellitus type 1 pathophysiology scribd jay cutler playing with diabetes pramlintide in the treatment of type 1 and type 2 diabetes mellitus i did question some parts of the story since it was so detailed. Diabetic ketoacidosis is an acute major life threatening complication of diabetes mellitusdm mainly occurs with type 1 dm but not uncommon with some patients with type 2 it is a complex disordered metabolic state characterized by hypergycemia, ketoacidosis and ketonuria most common early symptom of dka are increase in polydipsia and polyuria. Diabetic ketoacidosis symptoms and causes mayo clinic.
Diabetic ketoacidosis dka care guidelines critical care individual rates of bag 1 and bag 2 are dependent on glucose level with goal of maintaining glucose of 150300. The insulin resistance preceding type 2 diabetes is commonly referred to as the metabolic syndrome. Pathophysiology of diabetic ketoacidosis free download as word doc. Hyperosmolar hyperglycemic state previously referred to as hyperglycemic hyperosmolar nonketotic coma hhnk and nonketotic hyperosmolar syndrome nkhs is a complication of type 2 diabetes mellitus and has an estimated mortality rate of up to 20%, which is significantly higher than the mortality for diabetic ketoacidosis currently quizlet. Nursing management of a patient with diabetic ketoacidosis. The goal of treatment is to correct the elevated blood glucose level by giving additional insulin and to replace fluids and electrolytes lost through excessive urination and vomiting. Main clinical features of dka are hyperglycemia, acidosis, dehydration, and electrolyte losses such as hypokalemia, hyponatremia.
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