ABOUT DIABETIC KETOACIDOSIS

1. PRESENTED BY : ( GROUP NO.5)
SUVIDHI JAIN
TANISHA AGARWAL
AKANKSHA GODARA
RAHUL SOROUT
ANKUR KUMAR

2. DEFINITION
• Diabetic ketoacidosis is defined as presence of all three of the
following features :
Hyperglycaemia (glucose > 250mg/dl)
Ketosis
Acidemia (pH<7.3)

3. PATHOGENESIS OF DIABETIC KETOACIDOSIS

4. SYMPTOMS
Weight loss
Dehydration
Fruity
smelling
breath
Stomach
pain, Nausea
and vomiting
Drowsiness

5. PRECIPITATING
EVENTS
Infection
Inadequate
insulin
administration
Drugs
(cocaine)
Infarction
Pregnancy
Identify precipitating factors
Assess hemodynamic status
Acid base assessment
Measure Serum & Urine ketones
Calculate serum osmolality and anion gap
Examine urine & blood glucose concentration
DIAGNOSIS :

6. 1. 2.
3. 4.

7. COMPLICATIONS OF DKA :
SHOCK
• If not improving with
fluids risk of
Myocardial Infarction.
VASCULAR THROMBOSIS
• Severe dehydration
• Cerebral vessels affected
• Occurs hours to days after DKA
PULMONARY EDEMA
• Result of aggressive fluid
resuscitation.
CEREBRAL EDEMA
• First 24 hours
• Mental status changes
• May require intubation
with hyperventilation.

8. MONITORING
Flow sheet maintained tabulating mental status, vital signs,
insulin dose , fluid & electrolyte administered and urine
output.
Capillary glucose every 1-2 hr , electrolytes (especially
potassium, bicarbonate and phosphate) and anion gap
every 4 hr for first 24 hr.
Monitor BP , Pulse , Respiration , fluid intake and output
every 1-4 hr.