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DKADiabetic Ketoacidosis

Most serious complication in Type 1 diabetes

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Precipitating Causes

Not enough insulinStress, traumainfections

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Pathophysiology of DKA

KetosisDehydrationElectrolyte imbalance

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Symptoms of DKAAbdominal painAnorexiaDehydrationFuity breathKussmaul’s

breathing Change LOCHypotensionN&V

PolyuriaSomnolenceTachycardiaThirstVisual disturbancesWarm, dry skinWeaknessWt. loss

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Intervention

RehydrateReverse shockGive PotassiumCorret pHGive insulin

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HHNKHyperglycemic, Hyperosmolar Noketotic Syndrome

Most commonly occurs in older adults with Type II diabetes

Always look for precipitating factors

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Factors Associated with HHNK

DrugsProceduresChronic illnessAcute illness

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Four Major Clinical Features

Severe hyperglycemiaNo or slight ketosisProfound dehydrationHyperosmolality

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Treatment

Similar to DKAFind underlying cause

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Hypoglycemia

Low blood glucose levels

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Risk Factors

Overdose of insulinOmitting a mealOverexertionNausea and vomitingAlcohol intake

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Symptoms of Hypoglycemia

AdrenergicShakinessIrritabilityNervousnessTachycardiaTremorHunger

NeuroglycopenicHeadacheMental illnessInability to

concentrateSlurred speechBlurred visioncoma

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Interventions

Mildcarbohydrate 10-15 gram

Severe dextrose IV

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Pathogenesis

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Diabetes Long-term Effects retinopathy -potential blindness,Nephropathy- may lead to renal failure,neuropathy with risk of foot ulcers,

amputation, Charcot joints, and features of autonomic dysfunction, including sexual dysfunction.

Vasculopathy-People with diabetes are at increased risk of cardiovascular, peripheral vascular and cerebrovascular disease.

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Diabetic retinopathy

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Diabetic foot

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Thank you!

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