A life-threatening medical emergency in diabetics secondary to insulin deficiency and characterized by hyperglycemia, ketosis, metabolic acidosis, electrolyte disturbances, and marke...
Recent illness, injury, or surgery
Changes in diet or medications
Missed insulin doses/noncompliance
Insulin pump failure
Weight loss in patients recently diagnosed with type 1 DM
Polyuria...
Oxygen and airway management, as needed
Establish IV access.
Cardiac monitoring
Start isotonic crystalloid solution (e.g., 0.9% saline, or lactated ringers bolus).
All, but mild ...
Monitor mental status, vital signs, and urine output q30–60min until improved and then q2–4h.
Monitor blood sugar q1h until <200 mg/dL and the...
American Diabetes Association. Standards of medical care in diabetes—2013. Diabetes Care. 2013;36(Suppl 1):S11–S66.
Sheikh-Ali M, Karon BS, Basu A, et al. Can serum beta-hydrox...
E10.10 Type 1 diabetes mellitus with ketoacidosis without coma
E13.10 Oth diabetes mellitus with ketoacidosis without coma
E10.11 Type 1 diabetes mellitus with ketoacidosis with coma
E13.11 Ot...
Admit if blood glucose >250 mg/dL, pH <7.3, HCO3 ≤15 mEq/L, and ketones in urine.
Potassium is falsely elevated due to acidosis; start replacement when K+ ≤5.2 mg/dL and urine out...
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<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...