Diabetic nephropathy occurs in 2040% of patients with diabetes and is the single leading cause of endstage renal disease esrd persistent albuminuria in the. The adobe flash plugin is needed to view this content. Argy resident february, 2007 diabetic ketoacidosis dka a state of absolute or relative insulin deficiency aggravated. The management is clearly presented and divided into a number of key steps in the care pathway. Diabetic foot ulcerations are one of the most common complications associated w diabetes with a global annual incidence of 6. In contrast, the mean age for diabetic ketoacidosis dka is early in the fourth decade of life. Presentations ppt, key, pdf logging in or signing up. Case study a 43yearold gentleman with a long history of type 2 diabetes 6 years, dyslipidemia and hypertension presented to the emergency department with a 6day history of weakness, fever, nausea, vomiting and a painful left foot with foul smelling pus discharge from ulcer.
It is characterized by a triad of increased total body ketone concentration, metabolic acidosis, and uncontrolled hyperglycemia. In addition to timely identification of the precipitating cause, the first step in acute management of these disorders includes aggressive administration of intravenous fluids with appropriate replacement of electrolytes primarily. All they had to do was offer to send a new one instead of blaming diabetic ketoacidosis nursing management diabetes mellitus treatment guidelines pdf ppt me and the problems would have been solved. Hyperglycemia is a key diagnostic criterion of dka.
Malaise, generalized weakness, and fatigability also can present as symptoms of dka. This deficiency in available insulin results in disorders in the metabolism of carbohydrate, fat, and protein. The 2009 american diabetes association ada position statement on hyperglycaemic emergencies in adult patients with diabetes details the management of diabetic ketoacidosis dka and hyperosmolar hyperglycaemia state. Powerpoint slide on diabetic ketoacidosis dka compiled by alairic reuben. This condition is a complex disordered metabolic state characterized by hyperglycemia, ketoacidosis, and ketonuria.
This section focuses on the medical management of type 2 diabetes. When blood sugar levels are too high and insulin levels are too low. More than 50% of diabetic ulcers become infected and 20% of. Diabetic ketoacidosis dka and hyperglycemic hyperosmolar state hhs are acute metabolic complications of diabetes mellitus that can occur in patients with both type 1 and 2 diabetes mellitus. It happens predominantly in those with type 1 diabetes, but it can occur in those with type 2 diabetes under certain circumstances. History insidious increased thirst ie, polydipsia and urination ie, polyuria are the most common early symptoms of diabetic ketoacidosis dka. American diabetes association presentation summary. Dka is a far more characteristic feature of type 1 than of type 2 diabetes but may be seen in persons with type 2 diabetes under conditions of stress. If not diagnosed and treated with insulin, the person with type 1 diabetes will eventually develop a lifethreatening condition known as diabetic ketoacidosis keytoeasidoesis or dka. The goal of treatment is to correct the elevated blood glucose level by giving additional insulin and to replace fluids and electrolytes lost through excessive urination and vomiting. Diabetic ketoacidosis a sweet new approach to an old problem outline dka background the new. The management of diabetic ketoacidosis in adults ketan dhatariya. The management of diabetic ketoacidosis in adults pdf 2m b order reference. The biochemical criteria for the diagnosis of diabetic ketoacidosis dka are.
Overlap the insulin drip with the sq insulin by 2 or more hours. Diabetic ketoacidosisdiabetic keto acidosis is an acute state of severeuncontrolled. Diabetic ketoacidosis university of pittsburgh powerpoint presentation presentation title. Diabetic ketoacidosis clinical presentation history insidious increased thirst ie, polydipsia and urination ie, polyuria are the most common early symptoms of diabetic ketoacidosis dka. Hospitalizations for diabetic ketoacidosis as firstlisted diagnosis in adults with diabetes, united states. Diabetic ketoacidosis 1 diabetic ketoacidosis irene n. The adage a child is not a miniature adult is most appropriate when considering diabetic ketoacidosis dka. In fact, one third of patients admitted for hyperglycemia exhibit characteristics of both hhs and dka. Reem sallam, md, msc, phd clinical chemistry unit, pathology dept. After you enable flash, refresh this webpage and the presentation should play. Practice guidelines resources american diabetes association. They include increased thirst and urination, hunger, weight loss, dry skin, and sometimes blurred vision. Guidelines for management of diabetic ketoacidosis. The new model standardised diagnosis check for high risk criteria standard fluid orders.
Diabetic ketoacidosis dka is a common, serious, and preventable complication of type 1 diabetes, with a mortality of 35%. Introduction hhs and dka are not mutually exclusive but rather two conditions that both result from some degree of insulin deficiency. Diabetic ketoacidosis management update slideshare. Diabetic ketoacidosis dka though preventable remains a frequent and life threatening complication of. It seems like you waste quite a lot of thi diabetic ketoacidosis nursing management ppt and then the product itself isnt worth it. Diabetic ketoacidosis singapore pdf ppt case reports. Presentation slides american association of diabetes.
Diabetic ketoacidosis is a serious complication of type 1 diabetes, though its sometimes seen in people with type 2 diabetes. The management is clearly presented and divided into a number of key steps in the care. Ketogenesis in the liver is triggered by low levels of insulin and high levels of glucagon. Sills, md albany medical center albany, ny 2 diabetic ketoacidosis presentation of new onset diabetes about 30 of the time is a lifethreatening emergency the metabolic abnormalities must be corrected in a careful, vigilant fashion 3 diabetic ketoacidosis. Diabetic ketoacidosis dka powerpoint slides myprivatetutor.
Timely diagnosis, comprehensive clinical and biochemical evaluation, and effective management is key to the successful resolution of dka and hhs. Treatment diabetic ketoacidosis is an emergency and requires urgent medical attention, often in and intensive care setting. As rates of obesity increase amongst children, the prevalence of type 2 diabetes mellitus is also rising in this age group and may lead to an increased incidence of hhs in this population. The management is clearly presented and divided into a. Ispad 2009, mcgeoch 2007, savage 2006, bsped 2004, kitabchi 2009. We examined the frequency and severity of diabetic ketoacidosis dka in 679 children and adolescents 014 years at diagnosis of type 1 diabetes mellitus t1dm in. Evolving strategies for diabetes education resources in the 21st century. Main clinical features of dka are hyperglycemia, acidosis, dehydration, and electrolyte losses such as hypokalemia, hyponatremia, hypocalcemia, hypomagnesemia, and. Diabetic ketoacidosis dka, a hallmark of type 1 diabetes, is the result of uncontrolled production of ketone bodies 3hydroxybuturate and acetoacetic acid, leading to a lowering of blood ph. Ppt diabetic ketoacidosis powerpoint presentation free to view id. Diabetic ketoacidosis dka management algorithm adult. Severe insulin deficiency occurs in previously undiagnosed type 1 diabetes mellitus. Diabetic ketoacidosis dka, though preventable, remains a frequent and life threatening. In the last decade, however, there has been a change in the way patients with dka present clinically and in addition there has been rapid development of nearpatient testing.
Dka adalah komplikasi akut dari diabetes melitus yang mengancam nyawa. Kad didefinisikan sebagai suatu trias yang terdiri dari hiperglikemi, ketonemia, dan asidosis. Diabetic ketoacidosis presentation of new onset diabetes about 30 of the time is a lifethreatening emergency the metabolic abnormalities must be corrected in a careful, vigilant fashion 3 diabetic ketoacidosis. Diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome hhs are life threatening complications that occur in patients with diabetes. Nauseavomiting thirstpolyuria abdominal pain shortness of breath physical findings. Diabetes state burden toolkit ddt burden toolkit home. Diabetic ketoacidosis free download as powerpoint presentation. Diabetic ketoacidosis dka is an acute, major, lifethreatening complication of diabetes that mainly occurs in patients with type 1 diabetes, but it is not uncommon in some patients with type 2 diabetes. Introduction diabetic ketoacidosis dka is a potentially life threatening complication in people with diabetes mellitus.
Diabetes insulin transition iv to subcutaneous adult supplemental 5254. Since there is considerable progress in the field of medicinenursing, there maybe interventions, drugs of choice, and other related factors that are still incorporated. Guidelines and position statements from medical organisations are widely used by clinicians to guide the care of their patients. You are free to use the slides in presentations without further permission as long as the slide content is not altered in any way and appropriate attribution is made to the american diabetes association the association name and logo on the slides constitutes appropriate attribution. Differential diagnosis of ketosis and anion gap acidosis features diabetic alcohol starvation uraemic ketoacidosis ketoacidosis ketoacidosis acidosis lactic acidosis ph plasma glucose anion gap serum ketones serum osmolality 14th edition of joslins diabetes mellitus 9. Pediatric diabetic ketoacidosis clinical presentation. A free powerpoint ppt presentation displayed as a flash slide show on id. It can also occur in patients with other types of diabetes. The fundamental pathophysiology of this potentially lifethreatening complication is the same as in adults. Diabetic ketoacidosis dka is a lifethreatening emergency caused by a relative or absolute deficiency of insulin. Ppt diabetes ketoacidosis powerpoint presentation free. After being a diabetic for many years, im happy to report that thanks to your. Current state of dsmt reimbursement and healthcare reform. Pdf euglycemic diabetic ketoacidosis, a misleading.
Diabetic ketoacidosis dka is one of the most serious complications of diabetes. Pathophysiology and treatment diabetic ketoacidosis dka, also known as diabetic acidosis or diabetic coma, is a severe complication of diabetes mellitus dm. At presentation, the specific deficits in an individual patient vary depending upon the duration and severity of illness, the extent. Diabetic ketoacidosis dka may be a complication existing type 1 diabetes mellitus or be the first. Diabetic ketoacidosis and hyperglycaemic hyperosmolar state gmed. The lifetime incidence of foot ulcers in diabetic patients is 19 34%. Diabetic ketoacidosis and hyperosmolar hyperglycemic. Diabetic ketoacidosis ppt presentation free download. Diabetic ketoacidosis dka results from deficiency of circulating insulin and increased levels of the counterregulatory hormones. The contents of this presentation is part of my notes in medicalsurgical nursing. The 2020 standards of medical care in diabetes includes all of adas current clinical practice recommendations and is intended to provide clinicians, patients, researchers, payers, and others with the components of diabetes care, general treatment goals, and tools to evaluate the quality of care. The management is clearly presented and divided into a number of. At presentation k level is normal or high k is shifted to ecc in. Ketoacidosis at first presentation of type 1 diabetes.
Diabetic ketoacidosis and hyperosmolar nonketotic coma diabetic ketoacidosis and hyperosmolar nonketotic coma diabetic ketoacidosis a condition precipitated by stress or other illness or omission of insulin insulin. However, the child differs from the adult in a number of characteristics. Diabetic ketoacidosis dka is considered to be a common presentation of both type 1 diabetes mellitus and type 2 diabetes mellitus in children and adolescents. Diabetic ketoacidosis hyperglycemia diabetes mellitus. Diabetic ketoacidosis, together with the major complication of cerebral edema, is the most important cause of mortality and severe morbidity in pediatric cases of diabetes, particularly at the time of first diagnosis. Ppt diabetic ketoacidosis powerpoint presentation free. Nursing assessment assess skin for dehydration like poor turgour,flushing, and dry mucus membrances. Ppt diabetic ketoacidosis powerpoint presentation free to download id.
Ppt diabetic ketoacidosis dka powerpoint presentation, free. Ketones positive result for urine or serum ketones by nitroprusside reaction. Remove this presentation flag as inappropriate i dont like this i like this remember as a favorite. More commonly seen in patients with type 1 diabetes t1d, dka results when lipid breakdown generates a surplus of acidic. Euglycemic diabetic ketoacidosis, a misleading presentation of diabetic ketoacidosis article pdf available in north american journal of medical sciences 76. Diabetic ketoacidosis powerpoint presentation how to treat diabetic peripheral neuropathy when to use insulin with type 2 diabetes which is worse type1 and type 2 diabetes why blurred vision in diabetes whiskey and diabetes type 2 where to go to get tested for diabetes. A comprehensive diabetic foot exam should be conducted by a podiatrist, physician or other health care provider who is knowledgeable about diabetes and its. Diabetic ketoacidosis australia pdf ppt case reports. Wednesday diabetes selfmanagement education dsme for preventable hypoglycemia.
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