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Diabetic Ketoacidosis

 Syn. DKA , Diabetic Ketosis , Ketoacidosis due to diabetes mellitus

Signs & Symptoms

 Abdominal pain
Ref: Uptodate [ Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis Clinical features and diagnosis of diabetic ketoacidosis in children and adolescents] Harrison [ 2870] Cecil [ 669]
Vomiting
Ref: Uptodate [ Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis Clinical features and diagnosis of diabetic ketoacidosis in children and adolescents] Harrison [ 2870] Cecil [ 669]
Nausea
Ref: Uptodate [ Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis Clinical features and diagnosis of diabetic ketoacidosis in children and adolescents] Harrison [ 2870] Cecil [ 669]
Polyuria
Note: Earliest
Ref: Uptodate [ Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis Clinical features and diagnosis of diabetic ketoacidosis in children and adolescents] Harrison [ 2870] Cecil [ 669]

Physical Examination

 Fatigue
Note: Older children and adolescents
Ref: Uptodate [ Clinical features and diagnosis of diabetic ketoacidosis in children and adolescents]
Tachycardia
Ref: Uptodate [ Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis Clinical features and diagnosis of diabetic ketoacidosis in children and adolescents] Harrison [ 2870] Cecil [ 669]
Dehydration
Ref: Harrison [ 2870]

Lab / Serology

 Hyponatremia
Note: Mild hyponatremia
Ref: Uptodate [ Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis]
Elevated serum osmolality
Note: 300–320 mosm/mL
Ref: Uptodate [ Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis] Harrison [ 2871]
Hyperglycemia
Note: Serum glucose > 13.9 mmol/L (>250 mg/dL)
Ref: Uptodate [ Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis] Harrison [ 2871] Cecil [ 669]

Imagin Study

Complication

 Coma
Ref: Uptodate [ Clinical features and diagnosis of diabetic ketoacidosis in children and adolescents] Harrison [ 2870] Cecil [ 669]
Venous thrombosis
Ref: Uptodate [ Treatment and complications of diabetic ketoacidosis in children and adolescents] Harrison [ 2872]
Cardiac arrhythmia
Ref: Uptodate [ Treatment and complications of diabetic ketoacidosis in children and adolescents]

Risk Factors

 Age < 65
Ref: Uptodate [ Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Epidemiology and pathogenesis]
Obesity
Ref: Uptodate [ Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Epidemiology and pathogenesis]

Cause

 Infection
Note: Pneumonia/UTI/gastroenteritis/ sepsis
Ref: Uptodate [ Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis] Harrison [ 2870] Cecil [ 669]
Gastroenteritis
Ref: Uptodate [ Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis] Harrison [ 2870] Cecil [ 669]
UTI
Ref: Uptodate [ Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis] Harrison [ 2870] Cecil [ 669]

Other