Table of Contents
What are the markers for DKA?
DKA is typically diagnosed when testing finds high blood sugar, low blood pH and ketoacids in either the blood or urine. The primary treatment of DKA is with intravenous fluids and insulin.
What are the main components in the management of DKA?
Cornerstones of management are: fluid and potassium replacement; weight-based fixed rate intravenous insulin infusion (FRIII); and close biochemical monitoring of capillary ketones, serum electrolytes, venous pH and capillary glucose.
What trace elements help insulin action?
Insulin action was reported to be potentiated by some trace elements like chromium, magnesium, vanadium, zinc, manganese, molybdenum and selenium [6].
How do you determine the severity of DKA?
While definitions vary, mild DKA can be categorized by a pH level of 7.25-7.3 and a serum bicarbonate level between 15-18 mEq/L; moderate DKA can be categorized by a pH between 7.0-7.24 and a serum bicarbonate level of 10 to less than 15 mEq/L; and severe DKA has a pH less than 7.0 and bicarbonate less than 10 mEq/L.
What happens to potassium in DKA?
Change in osmolality: The rise in plasma osmolality in DKA causes osmotic water movement out of the cells. Potassium also moves into the extracellular fluid due to the contraction of the intracellular fluid space, which favors passive potassium exit through potassium channels in the cell membrane.
Which element is present in insulin?
zinc crystals
Insulin is secreted in the form of zinc crystals. Zinc is required to maintain the structural integrity of the insulin. It works as a cofactor for the enzyme which is related to glucose metabolism. So, the element present in the trace in insulin is zinc.
Which minerals increase insulin sensitivity?
Many different supplements may increase insulin sensitivity, but chromium, berberine, magnesium, and resveratrol are backed by the most consistent evidence.
What are the stages of DKA?
An analysis of 1000 cases of diabetic ketoacidosis has suggested to the authors their classification into four evolutive stages: incipient ketoacidosis (normal pH, decrease of total CO2, between 20–26 mMol/l and of excess bases between -2 and -5 mMol/l), moderate ketoacidosis (pH 7.31-7.35, total CO2, between 15–19.9 …
How do you know if DKA is resolved?
How do you know when DKA is resolved? “DKA is resolved when 1) plasma glucose is <200–250 mg/dL; 2) serum bicarbonate concentration is ≥15 mEq/L; 3) venous blood pH is >7.3; and 4) anion gap is ≤12. The first three items can be checked with an accucheck and a BMP.
What happens to electrolytes in DKA?
During diabetic ketoacidosis, there may be rapid shifts in the plasma concentration of potassium ions. Although diabetic ketoacidosis leads to a deficit in total-body stores of potassium ion, the plasma concentration is usually normal or elevated, since the acidemia leads to the exit of potassium ions from cells.
What happens to sodium in DKA?
In DKA, we expect to find normal or low serum sodium due to the dilutional effect of hyperosmolar status caused by elevated blood glucose that shifts water from the intracellular space to the extracellular space.
What is the priority intervention for DKA?
After initial stabilization of circulation, airway, and breathing as a priority, specific treatment of DKA requires correction of hyperglycemia with intravenous insulin, frequent monitoring, and replacement of electrolytes, mainly potassium, correction of hypovolemia with intravenous fluids, and correction of acidosis.
Do you give potassium in DKA?
Replacement of potassium in intravenous fluids is the standard of care in treatment of DKA to prevent the potential consequences of hypokalemia including cardiac arrhythmias and respiratory failure.