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Diabetic keto acidosis
- 1. Diabetic -Keto-Acidosis(DKA) PRESENTED BY TUHIN MUKHERJEE TIYAS CHATTERJEE GURU NANAK INSTITUTE OF PHARMACEUTICAL SCIENCE AND TECHNOLOGY
- 2. CONTENTS: INTRODUCTION How it works? Polymer Gels Solvents and containers Samples Injection and injectors Column and column sets Pumps Detectors Discussion Theory Methodology/ Experimental setup Seperation procedure Advatages and disadvantages Application Conclusion References 2
- 3. INTRODUCTION Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. If left untreated or wrong treatment leads to coma and eventually death. Diabetic ketoacidosis occurs in 4.6–8.0 per 1000 people with diabetes annually. Up to 1% of children with DKA develop a complication known as cerebral edema. DKA mainly represented with lower pH of blood , Low bp, breathing problem, hypothermia, convulsion and finally coma state. 3
- 4. CAUSE : Risk of DKA type 1>Type 2. Due to , severe deficiency of insulin . Demand of insulin is increased in patient due to 1. improper communication with health care professionals. 2. Secondary infections in body. 3. Trauma ,surgery ,MI 4. Failure of taking insulin. 5. Problem with compliance . 4 1.Destructed Beta-islet cells in type 1 DM. Intercurrent situations
- 7. PATHOGENESIS SEVERE LIPOLYSIS: 7 FAT CELLS LPL ENZYME Fatty acids + glycerol. INSULI N
- 8. SYMPTOMS AND DIAGNOSIS 8 Normally Hco3- : 20-30 meq/L. ACETONE
- 9. SYMPTOMS AND DIAGNOSIS 9 KUSSMAUL BREATHING SWEET SMELL OF ACETONE IN BREATH. BLOOD GLUCOSE > 250 mg/dl BICARBONATE < 15 mg/dl KETONE > 5 mmol/L. POLYUREA POLYDYPSIA POLYPHAGIA KETONE STIMULATES CHEMOTRIGGER ZONE {NAUSEA, VOMITING}. DEHYDRATION. PANCREATITIS. { S.AMYLASE AND S.LIPASE TEST}. AZOTEMIA.
- 10. MANAGEMENT 10 . MANAGEMENT I.V RGULAR INSULIN FLUID REPLACEMENT ELECTROLYTE REPLACEMENT 1. POTASSIUM LOSS IN URINE . 2. MAGNESIUM AND PHOSPHATE LOSS IN URINE . 3. DUE TO POLYUREA BLOOD OSMOLARITY GOES UP AND PRODUCES THIRST.(POLYDIPSIA) 4. VOMITING AND FLUID LOSS. 5. DUE TO REDUCED BLOOD VLOUME AND ACIDOTIC VASODIALATION BP PROBLEMS FACED DURING MANAGMENT HYPEROSMOLARITY CNS
- 11. PREVENTION 11 1. Attacks of DKA can be prevented in those known to have diabetes to an extent by adherence to "sick day rules"; these are clear-cut instructions to person on how to treat themselves when unwell. Instructions include advice on how much extra insulin to take when sugar levels appear uncontrolled, an easily digestible diet rich in salt and carbohydrates, means to suppress fever and treat infection, and recommendations when to call for medical help.
- 12. REFERENCES: 12 1. Misra, S; Oliver, NS (28 October 2015). "Diabetic ketoacidosis in adults" . BMJ (Clinical Research Ed.). 351: h5660. doi:10.1136/bmj.h5660. hdl:10044/1/41091. PMID 26510442. 2. Ralston, Penman, Strachan, Hobson “principles and practice of Medicine” Davidson’s 23rd edition, ELSEVIER. 3. Glaser N (June 2018). "New perspectives on the pathogenesis of cerebral edema complicating diabetic ketoacidosis in children". Pediatric Endocrinology Reviews. 3 (4): 379–86. PMID 16816806 4. Misra, S; Oliver, NS (January 2016). "Utility of ketone measurement in the prevention, diagnosis and management of diabetic ketoacidosis". Diabetic Medicine. 32 (1): 14– 23. doi:10.1111/dme.12604. PMID 25307274. 5. DM Vasudevan, Sreekumari S, Kannan Vaidyanathan ‘TEXTBOOK OF BIOCHEMISTRY” 8TH EDITION. 6. Mohan Harsh “TEXTBOOK OF PATHOLOGY” 7TH EDITION , JAYPEE 7. Joint British Diabetes Societies Inpatient Care Group (September 2013). "The Management of Diabetic Ketoacidosis in Adults". p. 8. Archived from the original on 24 March 2016. Retrieved 14 August 2015.
- 13. DKA patient :doctor, what do you like in me? Doctor : I like the way you breath ... 13