DM Type 1 Case presentation

Question 1

What are some contributing factors to development of type I DM?

Answer 1

1. Genetic susceptibility
2. Multiple autoimmune mechanims
3. Environmental factors (possible triggeres) e.g. cocksackie, enterovirus

Question 2

What are the most likely predisposing factors for DKA?

Answer 2

1. prevously undiagnosed diabetes
2. infection
3. systemic illness
4. dehydration

Question 3

WHat are some features that are common to both Type I and II DM

Answer 3

1. Dehydration
2. insulin deficiency -either absolute or relative
3. Glucagon excess - either absolute or relative
4. Volume depletion
5. Mental status changes

Question 4

What are some clinical signs and symptoms seen in DKA

Answer 4

1. mental status changes
2. Fruity breath in acidosis
3. weight loss
4. Calculate anion gap
5. PUDPILES

Question 5

AEIOU TIPS is a pneumonics used to assess what change?

Answer 5

Mental status change. AEIOU TIPS stands for: 
Alcohol/Acidosis
Epilepsy/endocirne/exocine/encphlopahty
INfeciton
Opoid/Overdose
uremia
Trauma
Insulin 
Psychosis
Syncope/Stroke

Question 6

What are some common causes of DKA?

Answer 6

Inadequate insulin
Infection (Pneumonia, UTI, Gastroenteritis, sepsis); Infarction - any location (coronary, cerebral, msenteric peripheral); surgery; drugs (cocaine)

Question 7

What are the initial symptoms associated with DKA?

Answer 7

anorexia, nausea, vomitting, polyuria, thirst

Question 8

What are some progressive symptoms of DKA

Answer 8

abd pain; altered mental function, coma

Question 9

What are some physical findings associated with DKA

Answer 9

-Kussmaul respiration - rapid/deep
acetone breath odor
-dry mucous membranes 
-poor skin turgor
-tachycardia
-hypotension
-fever
-abd tenderness

Question 10

What are some laboratory findings of DKA?

Answer 10

• hyperglycemia
• Ketosis
• Metabolic acidosis (increased anion gap, decreased ABG, increas K+)
• hypertriglyceridemia
• hyperlipoproteinemia
• hyperamylasemia (salivary or can be suggestive of acute pancreatitis)
• leukocytosis