Diabetic Ketoacidosis

Diabetic Ketoacidosis is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Diabetic ketoacidosis (DKA):
    • Hyperglycemia
    • Ketosis
    • Metabolic acidosis
  • Mild DKA:
    • Arterial pH: 7.25–7.3
    • Serum bicarb (mmol/L): 15–18
    • Anion gap: >10
    • Mental status: Alert
  • Moderate DKA:
    • Arterial pH: 7.0–<7.24
    • Serum bicarb (mmol/L): 10–<15
    • Anion gap: >12
    • Mental status: Alert/drowsy
  • Severe DKA:
    • Arterial pH: <7.0
    • Serum bicarb (mmol/L): <10
    • Anion gap: >12
    • Mental status: Stupor/coma

Etiology

  • Inadequate insulin
  • Excess of counter-regulatory hormones (glucagon, catecholamines, growth hormones, and cortisol)
  • Medication noncompliance
  • Infection (sepsis, UTI, pneumonia)
  • New-onset diabetes
  • Pregnancy
  • Hyperthyroidism
  • Pancreatitis

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Basics

Description

  • Diabetic ketoacidosis (DKA):
    • Hyperglycemia
    • Ketosis
    • Metabolic acidosis
  • Mild DKA:
    • Arterial pH: 7.25–7.3
    • Serum bicarb (mmol/L): 15–18
    • Anion gap: >10
    • Mental status: Alert
  • Moderate DKA:
    • Arterial pH: 7.0–<7.24
    • Serum bicarb (mmol/L): 10–<15
    • Anion gap: >12
    • Mental status: Alert/drowsy
  • Severe DKA:
    • Arterial pH: <7.0
    • Serum bicarb (mmol/L): <10
    • Anion gap: >12
    • Mental status: Stupor/coma

Etiology

  • Inadequate insulin
  • Excess of counter-regulatory hormones (glucagon, catecholamines, growth hormones, and cortisol)
  • Medication noncompliance
  • Infection (sepsis, UTI, pneumonia)
  • New-onset diabetes
  • Pregnancy
  • Hyperthyroidism
  • Pancreatitis

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