DKA and types of diabetes

What signs will you see in someone with DKA?

Signs of dehydration: hypotension, tachycardia, low JVP
Signs of ketosis: Kussmaul breathing, fruity odour on breath

What do you expect to happen to the sodium levels in DKA?

Expect sodium to be low
If they are within normal ranges could mean severe dehydration

What type of ketone is raised in DKA?

Beta-hydroxybutyrate rather than acetoacetate

What are the three pillars of DKA management?

Fluid replacement
Potassium replacement
Insulin replacement

When do you replace potassium in DKA?

Potassium <5mmol

What's the dosing of an insulin infusion in DKA?

IV 0.1 units/kg bolus followed by infusion of 0.1 units/kg per hour

What's the scariest manifestation of DKA?

Cerebral oedema
Why you shouldn't treat too aggressively w fluids and insulin

What's the definition of diabetes on fasting blood glucose, random glucose, glucose tolerance test, HbA1c?

Fasting glucose: >7
Random glucose: >11.1
HbA1c: >6.5%
Glucose tolerance test: >11.1

What the definition of pre-diabetes on fasting blood glucose, glucose tolerance test, HbA1c?

Fasting glucose: 5.6-6.9
HbA1c: 5.7-6.4%
Glucose tolerance test: 7.8 - 11

Which auto-antibodies do you test for in T1DM?

Islet cell antibodies
Most commonly tested are anti GAD65 and IA-2