26y/M patient complaining fatigue since 2 days. k/c DM 2 on insulin. investigation report suggestive high level of acetone. management?

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Pt is in diabetic ketoacidosis Probably he has CKD As he is a kco DM2T Manage by hospitalisation Inj Ns+inj soda bicarbonate 7.5 % Inj insulin Sos inj dextrose See electrolytes It pt is in hypokalamia potassium drip also

Thanx dr Pushkar ji Bhomia
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IT'S A..CASE OF.. DIABETIC..KETOACIDOSIS.. DKA .. NEED'S.. * STRICT GLYCEMIC CONTROL WITH ANTIDIABETIC MANAGEMENT WITH EXPERTS OPINION.. * DRINK PLENTY OF WATER.. * FLUID REPLACEMENT WITH IV..NS .. * INSULIN TREATMENT.. * IMMEDIATE HOSPITALIZATION TO AVOID COMPLICATIONS..

Tnx Dr Shivraj Agarwal sir
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It is a case of diabetic ketoacidosis Basic causative etiology of diabetic ketoacidosis is absence of insulin or insufficiency of insulin This patient is already in insulin, therefore in this case he is having insufficient amount of insulin administered Therefore he needs further escalation in dose of insulin Based on arterial blood gas insulin, insulin can be given in infusion form, along with blood sugar titration He may be having latent autoimmune diabetes in adults (LADA DIABETES) To confirm same, serum C peptide level and Autoantibodies level need to be checked

Valuable opinion
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May we have blood sugar reports,Sir? Ketosis can be with hyperglycemia as well as with starvation . Patient is a TDM1 , and insulin dependant, Infections are common cause of tiredness as much as metabolic causes

RBS - 300 mg/dl
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It is a case of diabetic ketoacidosis Hospitalization under diabetologist and strict control of DM,Electrolyte control fluid management,blood sugar 4 hourly. Intensive treatment to avoid complications

I agree
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Strict control of diabetes... RBS 4 hrly.....and H.actrapid according to RBS give If dehydrated, fluid 2-3 liter stat give... Advise: Na+ k+ blood PH

Thank you doctor
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Strict control of DM with medicine, diet control and change in life style. Correct electrolyte imbalance by giving supplements. Plenty of liquid diet daily. Good nutritious balanced liquid diet. Regular evaluation and monitoring if not responding to oral supp than rehydrate body by iv route. Maintain I O chart.

Thanks Dr kute Ankush
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Strict control of diabetes Diuresis With normal saline & lasix Pottasium suppliment

Valuable opinion
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SUGGESTIVE OF DIABETIC KETOACIDOSIS... ADVISABLE... INDOOR MANAGEMENT

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@Dr. Dinesh Chaudhary

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