DKA case study
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This document describes a case of a 41-year-old female patient with type 1 diabetes mellitus who presented with loss of consciousness. She has a history of recurrent urinary tract infections. On examination, she was found to have diabetic ketoacidosis, as evidenced by ketones and high blood glucose levels on urinalysis and blood gas analysis. Diabetic ketoacidosis occurs when a lack of insulin causes fat breakdown and ketone production, resulting in metabolic acidosis. The document outlines the mechanisms, management, and importance of prevention of diabetic ketoacidosis through patient education and insulin therapy.
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4 types: FBS, PPBS, RBS, OGGT
Microalbuminurea
Ketones
HbA1C
Insulin
ICA (islent cell antibody) for type I
C-peptide
Acute complications of Diabetes Mellitus
This document discusses the acute complications of diabetes mellitus, including diabetic ketoacidosis, hyperglycemic hyperosmolar state, lactic acidosis, and hypoglycemic coma. It provides classifications, pathophysiology, clinical manifestations, investigations, management protocols, and case histories for each complication. Management involves addressing the underlying causes, rehydration, electrolyte and acid-base imbalances, and treatment of any complications. Hypoglycemia is also discussed, noting the importance of confirming low blood glucose and relieving symptoms.
Case of rds
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Case Study - Adult - Aspiration - Septic Shock
The patient was involved in an automobile accident, aspirated during orthopedic surgery and became septic.
He was intubated and had been taken off of vasopressors overnight but was looking worse the next morning.
CHIKODI IHEKUNA
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Acute complications of Diabetes
This document discusses acute complications of diabetes. It begins with objectives and an introduction on diabetes and its complications. Then it describes several acute complications in detail, including diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar nonketotic syndrome (HHNS), hypoglycemia, lactic acidosis, and diabetic coma. For each complication, it covers definition, causes, pathophysiology, signs and symptoms, diagnosis, treatment, and prognosis. The management of DKA and prevention strategies are also discussed in the Ethiopian healthcare context.
C13 nice type 2 diabetes 2008
This document provides an introduction to Type 2 diabetes, including:
- Type 2 diabetes is caused by insulin insensitivity and a failure of pancreatic insulin secretion to compensate. It is associated with obesity and other cardiovascular risk factors.
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Diabetes of stout people
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Mortality attributed to hyperosmolar hyperglycemic state (HHS) is considerably higher than that attributed to DKA, with recent mortality rates of 5–20%.
* Agenda:
Historical perspectives and diagnosis.
Pathophysiology.
Treatment issues.
Rhabdomyolysis: an overlooked complication.
Final bottom line and take home message.
Diabetic Nephropathy;Physiotherapy approach, a case report
Diabetic nephropathy is a complication of diabetes that results in chronic kidney disease. It is caused by damage to the glomeruli of the kidneys from hyperglycemia. It can progress to kidney failure if not controlled. The presentation includes edema, hypertension, reduced kidney function. Management involves controlling blood sugar and pressure with medications like ACE inhibitors. Prognosis depends on stage of disease and risk factors present, with proteinuria indicating higher mortality risk. Physiotherapy can help reduce pain and swelling and improve function for patients with diabetic nephropathy.
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Diabetes is a global epidemic that is increasing worldwide. Cardiovascular disease is the leading cause of death for diabetics, as they face comparable heart attack risks to those with a previous heart attack. The document reviews guidelines for glycemic, blood pressure, and lipid control to reduce cardiovascular risks and discusses various drug therapy options for treating diabetes in patients with cardiovascular disease.
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Recent studies have highlighted the growing global burden of type 2 diabetes, with over 600 million people projected to have the disease by 2045. In particular, Egypt will face explosive growth in cases. While control of blood sugar levels is important for reducing complications, most patients do not achieve treatment goals. Intensifying treatment in a timely manner when blood sugar is poorly controlled can reduce cardiovascular risks. Inertia on the part of both physicians and healthcare systems often limits timely treatment changes needed to improve outcomes for patients with type 2 diabetes.
Diabetic Ketoacidosis
This document provides an overview of diabetic ketoacidosis (DKA) including its pathophysiology, diagnosis, treatment, and complications. It then presents a case study of an 18-year-old female patient presenting with DKA symptoms including abdominal pain and vomiting. The patient's lab results indicate metabolic acidosis and ketosis. The document outlines her recommended treatment including IV fluids, insulin, antibiotics, and electrolyte replacement. It also discusses monitoring her response to therapy and educating her and her family about diabetes management and prevention of future DKA episodes.
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This document reports on 6 cases of new onset diabetes that appeared after kidney transplantation. It finds that 30% of kidney transplant patients in the studied population developed diabetes, with an average onset of 5 months post-transplant. Risk factors for developing diabetes included older age, family history, overweight status, and immunosuppressive medications. Treatment included insulin therapy, oral medications, and adjusting immunosuppression. Good glycemic control is important for transplant outcomes, but treatment must be carefully managed to avoid rejection.
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This document discusses non-diabetic renal disease in diabetic patients. It begins by describing diabetic nephropathy and its characteristics. It then discusses the prevalence of proteinuria in type 1 and type 2 diabetes. Several case studies are presented showing patients with atypical presentations for diabetic nephropathy who were found to have non-diabetic renal diseases like lupus nephritis or focal segmental glomerulosclerosis instead. The document emphasizes that a renal biopsy can identify these non-diabetic diseases and lead to improved outcomes versus assuming diabetic nephropathy. It reviews several studies finding prevalence rates of non-diabetic renal disease in diabetics ranging from 17-85% depending on biopsy criteria
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Euglycemic ketoacidosis: Missed complication of Diabetes
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
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This document discusses a protocol for a systematic review that aims to synthesize evidence on the relative risk of mortality in type 2 diabetes mellitus (T2DM). It provides background on the prevalence of T2DM and discusses inconsistencies in reported mortality rates. The systematic review will explore all-cause mortality risk in T2DM expressed as hazard ratios, and examine subgroups based on age, gender, socioeconomic factors and causes of death. The review expects to pool data from large cohort studies to accurately summarize the actual mortality risk in T2DM with limited bias and help direct future research.
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This document provides information about Fibrocalculous Pancreatic Diabetes (FCPD). It discusses the historical background and definitions of FCPD. FCPD is characterized by severe diabetes associated with chronic pancreatitis and pancreatic stones. It predominantly affects poor populations in tropical developing countries. The document outlines the diagnostic criteria and clinical presentation of FCPD. Imaging findings like pancreatic calcifications on X-ray and changes on ultrasound or ERCP support the diagnosis. The document also discusses the worldwide distribution of FCPD, genetic studies conducted, various theories about its etiopathogenesis, and principles of management including treatment of diabetes with diet and insulin.
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DKA case study
- 1. Anna Grinsted Jr Medicine and Surgery
- 2. Female 41 Type 1 Diabetes Mellitus PC: Loss of consciousness HPC: 12 hr LOC Preceded by 4hr period of confusion No reported activity or injury during LOC supra-pubic pain on awaking This has happened before – recurrent UTIs PMH: T1 DM diagnosed aged 24 Chronic Kidney Disease (stage 3) Charcot’s joint Peripheral neuropathy Ulcer on base of 1st metatarsal R Hypercholesterolaemia 23/11/09 1.15pm Ward C
- 3. DH - on admission Humalog 8-16 units with each meal Lantis 28 units each evening Omeprazole Rosuvastatin Amitriptyline NKDA FH – Mother Angina SH – Lives with partner Smoker 27 pack years No alcohol intake O/E -
- 4. Investigations Urine dip – Ketones +++ Glucose ++ Microhaematuria ABG – Glucose 26.1 mmol/L (3.9 -11 mmol/L random) pH 7.01 (7.35-7.45) pCO2 29 mmHg (35-45mmHg) HCO3- 14 mmol/L (24-30mmol/L) Anion gap and plasma osmolality elevated ECG, FBC, U+E, LFTs, CRP
- 5. Discussion: Diabetic Ketoacidsosis (DKA) Kitabchi et al, 2001 Management of Hyperglycemic Crises in Patients With Diabetes. Diabetes care Journal, Vol 24, No.1, January 2001.
- 6. Mechanisms behind DKA Lack of insulin Decreased uptake of glucose Hyperglyceamia Osmotic diuresis Dehydration Elevated counterregulatory hormones Increased hepatic glucose production Increased lipolysis, fatty acid oxidation Ketosis Metabolic acidosis
- 7. Management 1. Fluid balance 2. Replace Insulin 3. Treat and monitor the potassium level 4. Treat the underlying cause
- 8. Conclusion Patient education and concordance Insulin pump Prevention is better than cure!
- 9. Bibliography Longmore et al. 2007OxfordHandbook ofClinicalMedicine.7thedition . Oxford University Press. Rull, 2009. Diabetic Ketoacidosis. Copyright EMIS Available online http://www.patient.co.uk/doctor/Diabetic-Ketoacidosis.htm Accessed [17.01.10] Kitabchi et al, 2001 Management of Hyperglycemic Crises in Patients With Diabetes. Diabetes care Journal, Vol 24, No.1, January 2001. Berne & Levy, Principles of Physiology, 4th edition. 2006 Mosby Inc. Davey, P(ed.) 2006. Medicine at a Glance, Second edition. Fogel, N. and Zimmerman, D. Management of diabetic ketoacidosis in the emergency department. 2009 Diabetic Ketoacidosis In The Ed • Vol. 10, No. 4 Azoulay, E. et al. Infection as a Trigger of Diabetic Ketoacidosis in Intensive Care–Unit Patients. CID 2001:32 NICE Guidelines: Treatment of Type 1 Diabetes. Available online http://www.nice.org.uk/nicemedia/pdf/CG015NICEguideline.pdf Accessed [18.01.10] Umpierrez and Kitabchi, Diabetic ketoacidosis: risk factors and management strategies.Treatment of Endocrinology 2003;2(2):95-108. NHS Quick Reference NICE guidelines July 2008 Continuous subcutaneous insulin infusion for the treatment of diabetes mellitus. Available online http://www.nice.org.uk/nicemedia/pdf/TA151QuickRefGuide.pdf Accessed [19.01.10]
- 10. Bibliography Longmore et al. 2007OxfordHandbook ofClinicalMedicine.7thedition . Oxford University Press. Rull, 2009. Diabetic Ketoacidosis. Copyright EMIS Available online http://www.patient.co.uk/doctor/Diabetic-Ketoacidosis.htm Accessed [17.01.10] Kitabchi et al, 2001 Management of Hyperglycemic Crises in Patients With Diabetes. Diabetes care Journal, Vol 24, No.1, January 2001. Berne & Levy, Principles of Physiology, 4th edition. 2006 Mosby Inc. Davey, P(ed.) 2006. Medicine at a Glance, Second edition. Fogel, N. and Zimmerman, D. Management of diabetic ketoacidosis in the emergency department. 2009 Diabetic Ketoacidosis In The Ed • Vol. 10, No. 4 Azoulay, E. et al. Infection as a Trigger of Diabetic Ketoacidosis in Intensive Care–Unit Patients. CID 2001:32 NICE Guidelines: Treatment of Type 1 Diabetes. Available online http://www.nice.org.uk/nicemedia/pdf/CG015NICEguideline.pdf Accessed [18.01.10] Umpierrez and Kitabchi, Diabetic ketoacidosis: risk factors and management strategies.Treatment of Endocrinology 2003;2(2):95-108. NHS Quick Reference NICE guidelines July 2008 Continuous subcutaneous insulin infusion for the treatment of diabetes mellitus. Available online http://www.nice.org.uk/nicemedia/pdf/TA151QuickRefGuide.pdf Accessed [19.01.10]