26y/M patient complaining fatigue since 2 days. k/c DM 2 on insulin. investigation report suggestive high level of acetone. management?
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
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..
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
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
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
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
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.
@Dr. Dinesh Chaudhary
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D I A B E T I C K E T O A C I D O S I S Diabetic ketoacidosis (DKA) is a serious and potentially life-threatening complication of diabetes .It is a complex disordered metabolic state characterised by hyperglycaemia (elevated blood glucose), acidosis (pH imbalance) and ketonaemia (excess ketones in the blood). This deficiency in available insulin results in disorders in the metabolism of carbohydrate, fat, and protein. Main clinical features of DKA are hyperglycemia, acidosis, dehydration, and electrolyte losses such as hypokalemia, hyponatremia, hypocalcemia, hypomagnesemia, and hypophosphatemia. Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS) is a condition characterized by the presence of hyperglycemia, hyperosmolarity, and dehydration. There is enough production of insulin to reduce ketosis but not to control hyperglycemia. Persistent hyperglycemia causes osmotic diuresis, which results in the fluid and electrolyte imbalances. The clients with HHNS may present with symptoms of hypotension, tachycardia, marked dehydration, and neurological manifestation such as seizures, hemiparesis, and alterations in the sensorium).
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