5-Minute Emergency Consult
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:Description
- 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
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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Basics
Description
Insulin deficiency and excess of counterregulatory hormones (catecholamines, glucagon, growth hormone, and cortisol) resulting in:Description
- 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
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
Rosen, Peter, et al., editors. "Diabetic Ketoacidosis." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307314/all/Diabetic_Ketoacidosis.
Diabetic Ketoacidosis. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307314/all/Diabetic_Ketoacidosis. Accessed February 27, 2020.
Diabetic Ketoacidosis. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult (5th edition). Lippincott Williams & Wilkins. Retrieved February 27, 2020, from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307314/all/Diabetic_Ketoacidosis
Diabetic Ketoacidosis [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2020 February 27]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307314/all/Diabetic_Ketoacidosis.
* Article titles in AMA citation format should be in sentence-case
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