Brief list diebetes millitis complication

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Brief list diebetes millitis complication

  1. 1. Acute complications of D.M <ul><li>Hypoglycaemia. </li></ul><ul><li>D.K.A </li></ul><ul><li>H.N.C </li></ul><ul><li>L.A </li></ul>
  2. 2. Cont. <ul><li>Acute complications of diabetes are medical emergencies. </li></ul><ul><li>Both type1 and type2 diabetes can experience life threatening crises. </li></ul>
  3. 3. HYPOGLYCAEMIA <ul><li>Definition </li></ul><ul><li>Lowered blood glucose level <2.5mgdl </li></ul><ul><li>Mortality rate 2% to 4% </li></ul>
  4. 4. Risk factors <ul><li>1)Missed meal . </li></ul><ul><li>2)Unexpected exercise. </li></ul><ul><li>3)Alcohol . </li></ul><ul><li>4)Poorly designed insulin. </li></ul><ul><li>5)Defective glucose counter regulation. </li></ul><ul><li>6)Gastro paresis. </li></ul><ul><li>7)Addison's disease. </li></ul><ul><li>8)Mal absorption. </li></ul><ul><li>9)Liver failure. </li></ul>
  5. 5. CP <ul><li>1)Autonomic activation </li></ul><ul><li>2)Neuroglycopenic </li></ul>
  6. 6. Morbidity <ul><li>CNS…coma brain damage CVA TIA </li></ul><ul><li>CVS…cardiac arrhythmias MI </li></ul><ul><li>EYE…vitreous hemorrhage worsening retinopathy </li></ul>
  7. 7. Investigations <ul><li>RBS…BF…LFT…US </li></ul>
  8. 8. Treatment <ul><li>1)Oral glucose </li></ul><ul><li>2)IV dextrose </li></ul><ul><li>3)Glucagons </li></ul>
  9. 9. D.K.A <ul><li>Definition </li></ul><ul><li>Absolute insulin def, with hyperglycemia >300mgdl </li></ul><ul><li>Lipolysis ..hyperketonaemia and acidosis </li></ul>
  10. 10. Risk factors <ul><li>New cases </li></ul><ul><li>Infections </li></ul><ul><li>Surgery... trauma e.g. MI </li></ul><ul><li>Interruption of insulin administration </li></ul><ul><li>Emotional factors and stress </li></ul>
  11. 11. CP <ul><li>Abdominal pain, nausea and vomiting </li></ul><ul><li>SS of dehydration </li></ul><ul><li>Polyuria </li></ul><ul><li>Kussmaul respiration </li></ul>
  12. 12. Investigations <ul><li>Urine……glucosuria and ketonuria </li></ul><ul><li>Blood…...hyperglycaemia>300mg/dl </li></ul><ul><li>Serum electrolytes(Na, K, Ph,…) </li></ul><ul><li>AGB and PH </li></ul><ul><li>Plasma bicarbonate <12mmol/L </li></ul>
  13. 13. Management <ul><li>Correction of dehydration </li></ul><ul><li>Correction of hyperglycemia </li></ul><ul><li>Correction of electrolytes </li></ul><ul><li>Treatment of infection </li></ul>
  14. 14. Hyper osmolar Non Ketotic Coma <ul><li>Definition </li></ul><ul><li>Relative insulin def, +hyperglycemia >600mg/dl ass. </li></ul><ul><li>With increase serum osmolarity >310 mosm/L </li></ul><ul><li>Sever dehydration + stupor….coma </li></ul>
  15. 15. Risk factors <ul><li>Age </li></ul><ul><li>Dehydration </li></ul><ul><li>Acute illness </li></ul><ul><li>Cerebrovascular disease </li></ul><ul><li>Medications…steroids…thiazids </li></ul>
  16. 16. CP <ul><li>SS of sever dehydration </li></ul><ul><li>Stupor……..Coma </li></ul>
  17. 17. Investigation <ul><li>1) Measurement of plasma osmolarity </li></ul><ul><li>2[Na] +2[k] + [glucose] + [urea] </li></ul><ul><li>N… (280 to 300) </li></ul><ul><li>2) RBS </li></ul><ul><li>3) Urine </li></ul>
  18. 18. Treatment <ul><li>Correct dehydration </li></ul><ul><li>Correct hyperglycemia </li></ul><ul><li>Correct electrolytes </li></ul>
  19. 19. Lactic acidosis <ul><li>Definition </li></ul><ul><li>Lactic acidemia >2mmol/L + acidosis (PH<7.3) and </li></ul><ul><li>Without ketoacidosis maybe low keton level </li></ul>
  20. 20. Risk factors <ul><li>Sex </li></ul><ul><li>Age </li></ul><ul><li>Hypoxia </li></ul><ul><li>Drugs </li></ul><ul><li>Acute illness </li></ul>
  21. 21. CP <ul><li>Similar to DKA </li></ul>
  22. 22. Investigations <ul><li>RBS </li></ul><ul><li>PH AND Bicarbonate levels </li></ul><ul><li>Lactic acid level </li></ul>
  23. 23. Treatment <ul><li>Dehydrations </li></ul><ul><li>Electrolytes balance </li></ul><ul><li>Correction of acidosis </li></ul><ul><li>Correction of hyperglycemia </li></ul>
  24. 24. Thank You

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