A life-threatening medical emergency in diabetics, which most commonly occurs in patients with type 1 diabetes
Characterized by a biochemical triad of hyperglycemia, ketosis, and high...
Diagnostic criteria (1)[C]
Hyperglycemia (usually 250-800 mg/dL) as rapidly assessed on fingerstick glucose testing and confirmed on serum chemistry
Low HCO3 (usually ≤18 mEq/L)
Metabolic acid...
Fluid resuscitation
Resolution of anion gap acidosis and ketosis
Insulin therapy to normalize serum glucose
Correction of electrolytes
Identify and treat precipitating cause(s)
NPO initially, advance diet when nausea and vomiting are controlled.
Avoid foods with high glycemic index (e.g., soft drinks, fruit juice, white bread, added sugar, etc.).
DKA is defined by a classic clinical triad of hyperglycemia, ketosis and high anion gap metabolic acidosis.
Admit if blood glucose >250 mg/dL, pH <7.3, HCO3 ≤15 mEq/L, and ketones...
E10.11 Type 1 diabetes mellitus with ketoacidosis with coma
E10.10 Type 1 diabetes mellitus with ketoacidosis without coma
E13.11 Other specified diabetes mellitus with ketoacidosis with coma
...
Sign up for a 10-day FREE Trial now and receive full access to all content.
<bold><italic>Figure 14.60.</bold></bold> Pretibial diabetic skin changes: necrobiosis lipoidica diabeticorum.
FIG. 11 Diabetic patient with acute spontaneous onset of low back pain and fever. <bold>A,B:</bold> Dramatic elements of two-level spondylodiscitis, L3-5, with secondary communicating psoas abscess component.
FIG. 11 Diabetic patient with acute spontaneous onset of low back pain and fever. <bold>A,B:</bold> Dramatic elements of two-l...
<bold>Figure 11.93. Neuropathic (Charcot) joints in two diabetic patients. A.</bold> Radiographs of both feet show bilateral neuropathic joints at the first metatarsophalangeal joints (<italic>arrows</bold>). On the left there is periarticular osteopenia, indicating superimposed infection. Frontal <bold>(B)</bold> and lateral <bold>(C)</bold> knee radiographs of another patient show disintegration of the knee joint with considerable bony debris (" bag of bones") and a large joint effusion. In the past, involvement o...
<bold>Figure 11.93. Neuropathic (Charcot) joints in two diabetic patients. A.</bold> Radiographs of both feet show bilateral n...