Cracking the Code: Understanding Diabetes, DKA, and Acid-Base Disorders in the ER

🩸Diabetes is highly prevalent in the United States, and clinicians should be aware of the signs and symptoms, such as polyuria, polydipsia, and slow-healing wounds.

🥤Diabetic ketoacidosis (DKA) is a metabolic derangement that occurs due to insulin deficiency, causing hyperglycemia, ketosis, and anion gap metabolic acidosis.

🌡️DKA can present with symptoms such as polyuria, polydipsia, lethargy, abdominal pain, and fruity breath odor.

🩹In addition to hyperglycemia and ketonuria, key lab findings in DKA include elevated anion gap, low bicarbonate levels, and electrolyte imbalances.

⚕️Treatment of DKA involves fluid resuscitation, insulin administration, correction of electrolyte abnormalities, and addressing the underlying cause.

What are the symptoms of diabetes?

—Common symptoms of diabetes include polyuria (excessive urination), polydipsia (excessive thirst), slow-healing wounds, recurrent infections, and unexplained weight loss.

How is diabetic ketoacidosis diagnosed?

—Diabetic ketoacidosis (DKA) is diagnosed based on a combination of high blood glucose levels, ketonuria (presence of ketones in urine), anion gap metabolic acidosis, and clinical signs and symptoms.

What is the treatment for DKA?

—The treatment of DKA involves fluid resuscitation with intravenous fluids, administration of insulin, correction of electrolyte imbalances (such as potassium and bicarbonate), and addressing the underlying cause of DKA.

How can DKA be prevented?

—DKA can be prevented by proper management of diabetes, including regular monitoring of blood glucose levels, adherence to insulin or oral medications, and management of any underlying illnesses or stressors.

What are the long-term complications of diabetes?

—Long-term complications of diabetes include cardiovascular disease, kidney disease, nerve damage, eye problems, and foot complications. Proper management of diabetes can help prevent or delay these complications.

00:00In this video, we discuss the topic of diabetes, diabetic ketoacidosis (DKA), and acid-base disorders in the emergency department.

03:45Diabetes is highly prevalent in the United States, and recognizing the signs and symptoms is essential for clinicians.

09:20DKA is a metabolic derangement caused by insulin deficiency, leading to hyperglycemia, ketosis, and metabolic acidosis.

14:15Common symptoms of DKA include polyuria, polydipsia, lethargy, abdominal pain, and fruity breath odor.

20:30Key lab findings in DKA include high blood glucose levels, ketonuria, elevated anion gap, low bicarbonate levels, and electrolyte imbalances.

25:10Treatment of DKA involves fluid resuscitation, insulin administration, correction of electrolyte abnormalities, and addressing the underlying cause.