Pathophysiology & Causes
What are Kussmaul respirations?
Deep, rapid breaths as body tries to expel CO2 to compensate for the metabolic acidosis
What is the main IV fluid of choice for DKA volume replacement?
0.9% NS
In which type of diabetes is DKA more commonly seen in?
Type 1 diabetes
Common symptoms of DKA?
Early: polydipsia, polyphagia, polyuria
Later: Kussmaul resps, fruity-smelling breath, altered LOC, hypotension, tachycardia
What is the main diagnostic triad of DKA?
Hyperglycemia + Metabolic Acidosis + Ketones
Why is hypokalemia a complication of DKA treatment?
Insulin drives potassium into the cells which can rapidly decline serum potassium to dangerous levels
Causes of DKA?
- Missed insulin doses
- Medication non-adherence
- Inability to access/afford medications
- Physiological stress: infection, MI, trauma, drugs
What are the 3 components that mainly make up DKA treatment?
IV Fluids + Potassium + Insulin
How can DKA lead to acute kidney injury?
Severe dehydration and hypovolemia from diuresis reduces perfusion to kidneys which impairs kidney function
What causes metabolic acidosis in DKA?
Ketones - body can't access glucose so it breaks down fats for energy, ultimately leading to ketone production, which is acidic and lowers pH
How many mmol/L per hour is considered a safe rate of decrease for blood glucose?
3-4 mmol/L per hour
What is the rare and life-threatening complication of DKA?