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    Diabetic Ketoacidosis

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

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    Basics

    Description

    Insulin deficiency and excess of counterregulatory hormones (catecholamines, glucagon, growth hormone, and cortisol) resulting in:
    • Dehydration (osmotic, hyperglycemic, diuresis, and decreased oral intake)
    • Acidosis (anion gap metabolic acidosis)
    • Ketone formation (unrestrained lipolysis and ketogenesis)
    • Hyperglycemia (unrestrained glycogenolysis and gluconeogenesis)
    • Electrolyte disturbances (hypokalemia, hypo/hypernatremia, hypophosphatemia)

    Etiology

    • Medication noncompliance (>50%)
    • New-onset diabetes (type I or II)
    • Underlying medical illness (increased counterregulatory hormones and insulin resistance):
      • Infectious process
      • MI
      • GI bleed
      • CNS event
    • Pregnancy (relative insulin deficiency and counterregulatory hormone excess)
    • Medications (protease inhibitors and atypical antipsychotics: Olanzapine, clozapine)
    • Alcohol abuse

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    Citation

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    TY - ELEC T1 - Diabetic Ketoacidosis ID - 307314 ED - Barkin,Adam Z, ED - Barkin,Roger M, ED - Hayden,Stephen R, ED - Rosen,Peter, ED - Schaider,Jeffrey J, ED - Shayne,Philip, ED - Wolfe,Richard E, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307314/all/Diabetic_Ketoacidosis PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -