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    Acute Complication of DM: Clinical Manifestation Laboratory Procedures Therapeutic Plan Possible Problem Associated

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    iron
    This document discusses acute complications of diabetes mellitus, specifically diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS). Both are caused by insulin deficiency and dehydration and can be precipitated by infections or other illnesses. DKA is characterized by hyperglycemia, ketosis, and metabolic acidosis while HHS features extreme hyperglycemia and hyperosmolarity. Treatment for both involves careful rehydration and monitoring of fluid status and insulin administration to avoid complications like cerebral edema, hypokalemia, or hypoglycemia.

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    Acute Complication of DM: Clinical Manifestation Laboratory Procedures Therapeutic Plan Possible Problem Associated

    Uploaded by

    iron
    76 views12 pages
    This document discusses acute complications of diabetes mellitus, specifically diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS). Both are caused by insulin deficiency and dehydration and can be precipitated by infections or other illnesses. DKA is characterized by hyperglycemia, ketosis, and metabolic acidosis while HHS features extreme hyperglycemia and hyperosmolarity. Treatment for both involves careful rehydration and monitoring of fluid status and insulin administration to avoid complications like cerebral edema, hypokalemia, or hypoglycemia.

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    DM

    Original Title

    Acute Complication of Dm

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    This document discusses acute complications of diabetes mellitus, specifically diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS). Both are caused by insulin deficiency and dehydration and can be precipitated by infections or other illnesses. DKA is characterized by hyperglycemia, ketosis, and metabolic acidosis while HHS features extreme hyperglycemia and hyperosmolarity. Treatment for both involves careful rehydration and monitoring of fluid status and insulin administration to avoid complications like cerebral edema, hypokalemia, or hypoglycemia.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    76 views12 pages

    Acute Complication of DM: Clinical Manifestation Laboratory Procedures Therapeutic Plan Possible Problem Associated

    Uploaded by

    iron
    This document discusses acute complications of diabetes mellitus, specifically diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS). Both are caused by insulin deficiency and dehydration and can be precipitated by infections or other illnesses. DKA is characterized by hyperglycemia, ketosis, and metabolic acidosis while HHS features extreme hyperglycemia and hyperosmolarity. Treatment for both involves careful rehydration and monitoring of fluid status and insulin administration to avoid complications like cerebral edema, hypokalemia, or hypoglycemia.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 12

    ACUTE COMPLICATION OF DM

    CLINICAL MANIFESTATION
    LABORATORY PROCEDURES
    THERAPEUTIC PLAN
    POSSIBLE PROBLEM ASSOCIATED
    Acute Complication of DM
    Comprises 2 condition:
    Diabetic Ketoacidosis (DKA) primarily seen
    in type 1 DM
    Hyperglycemin Hyperosmolar State (HHS)
    primarily seen in type 2 DM
    Both disorder associated w/:
    Absolute or relative insulin deficiency
    Volume depletion
    Acid-base abnormalities
    Serious complication if not promptly
    diagnosed or treated
    Diabetic Ketoacidosis (DKA)
    Primarily found in type 1 DM
    Associated with acidosis and ketosis
    Characteristics:
    Hyperglycemia
    Ketosis
    Metabolic acidosis
    Precipitated by:
    Inadequate insulin administration
    Infection Pneumonia, UTI, Gastroenteritis, Sepsis
    Infarction Cerebral, Coronary, Mesentery,
    Peripheral
    Drugs cocaine
    Pregnancy
    Pathophysiology of DKA
    Relative or absolute Counterregulatory
    insulin deficiency hormone action

    Disturbance in Disturbance in lipid


    glucose metabolism metabolism

    Glucose overproduction Excess conversion of FFA


    to acetyl-coA than use

    Accumulation of Ketone bodies


    Hyperosmolarity Glycosuria

    Osmotic diuresis Ketonemia & Severe acidosis

    Hypovolemia

    Tissue hypoxia lactic Ketonuria


    acidosis production
    Decrease cerebral blood Tachypnea
    flow coma
    Hyperviscosity - thrombosis
    Hyperglycemic Hyperosmolar State
    (HHS)
    Primarily found in DM type 2 and older patient
    Clinical pictures:
    Hyperosmolarity (>320 mOsm/L)
    Hyperglycemia (> 600 mg/dL)
    Dehydration
    Precipitated by:
    Serious, concurrent illnesses MI
    Sepsis, Pneumonia, and other serious infection
    Debilitating conditions Stroke or dementia
    Condition compromising water intake
    Patient feature:
    Old age
    Mental status changes
    Accompanying co morbidities condition
    Pathophysiology of HHS
    Inadequate fluid intake Relative insulin
    deficiency

    Hepatic glucose production


    Impairs glucose utilization in periphery

    Hyperglycemia

    Osmotic diuresis

    Intravascular volume depletion

    Mental convulsion, lethargy, coma


    CLINICAL MANIFESTATION
    DKA HHS
    Several week
    Onset Develops over 24 history of
    h polyuria, wt loss
    and diminished
    oral intake
    Nausea & vomiting
    Thirst/Polyuria
    Abdominal
    pain/tenderness
    Dyspnea
    Tachycardia
    Dry mucous membrane
    Dehydration/hypovolemia
    Tachypnea/kussmauls
    breath
    LABORATORY PROCEDURE
    THERAPEUTIC PLAN
    Volume depletion and hyperglycemia are
    prominent features of both complications
    Consequently, the management for both
    share the several elements
    Crucial:
    Careful monitoring of fluid status
    Laboratory values
    Insulin infusion rate
    Fluid Loss:
    DKA 3-5 L
    HHS 9-10 L
    THERAPEUTIC PLAN
    POSSIBLE PROBLEM
    ASSOCIATED
    Most common complication of DKA is
    cerebral edema from hypervolemia
    Hypokalemia may lead to cardiac arrest
    Hypoglycemia from insulin administration

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