What is DKA and how is it treated?

Diabetic ketoacidosis is treated with fluids, electrolytes — such as sodium, potassium and chloride — and insulin. Perhaps surprisingly, the most common complications of diabetic ketoacidosis are related to this lifesaving treatment.

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Similarly one may ask, how is DKA treated in ICU?

TREATMENT OPTIONS IN THE ED OR ICU

The treatment of acute DKA includes restoration of fluid deficits in the first 24 to 36 h, electrolyte replacement and insulin therapy, which is administered slowly to decreased plasma glucose[23,24].

One may also ask, how much insulin is in DKA? A mix of 24 units of regular insulin in 60 mL of isotonic sodium chloride solution usually is infused at a rate of 15 mL/h (6 U/h) until the blood glucose level drops to less than 180 mg/dL; the rate of infusion then decreases to 5-7.5 mL/h (2-3 U/h) until the ketoacidotic state abates.

Thereof, what are the 3 P’s of DKA?

The three Ps of DKA:

Polydipsia—thirst. Polyuria—urination. Polyphagia—appetite.

What is DKA nice?

High blood glucose (hyperglycaemia) that is not treated can lead to a serious condition called diabetic ketoacidosis (or DKA for short). It is caused by the build‑up of harmful ketones in the blood. People with type 1 diabetes are at risk of DKA.

What is the difference between DKA and HHS?

DKA is characterized by ketoacidosis and hyperglycemia, while HHS usually has more severe hyperglycemia but no ketoacidosis (table 1). Each represents an extreme in the spectrum of hyperglycemia. The precipitating factors, clinical features, evaluation, and diagnosis of DKA and HHS in adults will be reviewed here.

What is the DKA protocol?

Key DKA management points

Start intravenous fluids before insulin therapy. Potassium level should be >3.3 mEq/L before the initiation of insulin therapy (supplement potassium intravenously if needed). Administer priming insulin bolus at 0.1 U/kg and initiate continuous insulin infusion at 0.1 U/kg/h.

What ketone level is DKA?

Check your blood sugar and ketone levels

lower than 0.6mmol/L is a normal reading. 0.6 to 1.5mmol/L means you’re at a slightly increased risk of DKA and you should test again in 2 hours. 1.6 to 2.9mmol/L means you’re at an increased risk of DKA and should contact your diabetes team or GP as soon as possible.

What type of insulin do you give in DKA?

The mainstay in the treatment of DKA involves the continuous intravenous (IV) infusion of regular insulin or the frequent subcutaneous (SC) injections of regular or rapid-acting insulin analogs.

When do you give Bicarb to DKA?

Consensus guidelines for the management of DKA recommended administering sodium bicarbonate to DKA patients who present with an initial blood gas pH of < 7.0. That recommendation was updated and changed in 2009 to limit sodium bicarbonate use to DKA patients with blood gas pH of < 6.9.

When do you give potassium in DKA?

About two-thirds of patients will develop hypokalemia in the course of treatment for DKA. Potassium repletion should commence once the serum potassium falls below 5.3 mEq/L if patients have normal renal function. Twenty to 30 mEq of potassium may be supplemented to each liter of fluids.

Why do we give dextrose in DKA?

Why is IV dextrose given to patients with DKA? When the serum glucose reaches 200 mg/dL in a patient with diabetic ketoacidosis (DKA), IV dextrose is added to avoid the development of cerebral edema. In addition, the rate of insulin infusion may need to be slowed down to between 0.02 and 0.05 units/kg/hr.

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