DKA

Question 1

What is the pathophysiology of DKA?

Answer 1

DKA occurs when the body cannot produce sufficient insulin.

The body begins to break down fatty acids for fuels which releases ketones which are acidic.

Question 2

What factors can increase risk of DKA?

Answer 2

1. Missing insulin doses or not taking as prescribed
2. Infection such as pneumonia, UTI or sepsis
3. Undiagnosed T1DM
4. Stomach illness with a lot of vomiting

Question 3

What is the diagnostic criteria for DKA?

Answer 3

1. Hyperglycaemia >11mmol/L (blood glucose)
2. Ketones >3mmol/L (blood ketones)
3. Acidosis, pH <7.3 (Metabolic acidosis)

Question 4

What are the clinical features of DKA?

Answer 4

Increased urination, increased thirst
N+V
Abdominal pain (especially in children)
Fruity breath
Deep hyperventilation (Kussmaul’s sign)

Question 5

How do you manage DKA?

Answer 5

Stop SA insulin + continue LA insulin
0.1units/kg/hr of insulin