Dka Case Study

I think Sally is experiencing metabolic acidosis, and the respiratory response is hyperventilation which increases loss of CO2 hence the reason she is breathing deeply and gasping. Also, if compensation is complete, pH will be within normal range but HCO3- will be low.

“Diabetes is a silent killer” (Demille 2005, p.5). It is a metabolic disorder that can result in impaired quality of life and serious complications. This study aims to understand the case of Mr. Skyler Hanson who is newly diagnosed with Diabetes Mellitus Type 1 that leads to diabetic ketoacidosis which was confirmed by the presence of moderate to high ketones in the urine and a high blood glucose level. It was noted that he has a history of fatigue, headache, abdominal pain, nausea and frequent urination. Furthermore, it was disclosed that he has difficulty in adjusting to his diagnosis and he occasionally missed administration of insulin dose when socialising. Subsequently, he was admitted in the Critical Care Unit for rehydration,

Diabetes Mellitus is a growing issue for health care providers internationally. The World Health organization estimated in 2013 there were 347 Million diabetics worldwide, predicting that Diabetes will be the 7th leading cause of death by 2030 (WHO, 2013). In both type 1 and type 2 diabetes Mellitus, factors such as poor compliance with diet and medication, infection, acute medical or surgical illness or trauma can lead to poor glycaemic control, precipitating a hyperglycaemic emergency such as Diabetic Ketoacidosis (DKA) (Scobie & Samaras, 2009). In Type 2 Diabetes, another equally dangerous

DKA is presented with three major physiological disturbances which are hyperosmolality due to hyperglycemia, metabolic acidosis because of the buildup of ketoacids, and hypovalemia from osmotic diuresis. Diabetic ketoacidosis is caused by a profound deficiency of insulin, its most likely occur in people with type 1 diabetes, inadequate insulin dosage, poor self management, undiagnosed type 1 diabetes, illnesses and infections. In type 1

Diabetic ketoacidosis is considered to be one of the most life threatening complications for Type 1 diabetics. Along with it being the most common cause of death in Type 1 diabetics under the age of 40 (Mills & Stamper, 2014). Diabetic ketoacidosis, also known as DKA, is when there are consistently high levels of glucose in the blood and not enough insulin to allow the body to function properly. The body then begins to breakdown body tissue in order to create energy in lieu of glucose. Acidic ketones begin to build up in the body and become toxic (Mills & Stamper, 2014). The amount of patients that are admitted to the hospital for a DKA episode are staggering, approximately 8,400 people were admitted from the span of April 2010 to March 2011.

Classic symptoms of diabetes usually presented with newly diagnosed diabetics are: hyperglycaemia, polyuria, polydipsia, polyphagia, fatigue, blurred vision, headaches, and unexplained weight loss. Ketone bodies are found in the urine, this abnormal finding occurs when fatty acid by-products (acetones) are excreted in the urine. The ketones are present from a lack of the insulin hormone used to metabolize fats and carbohydrates. Diabetic ketoacidosis (DKA) is a life-threatening complication which results from minimal useful insulin hormone in the body, hypoglycaemia, or insufficient food intake (American Diabetes Association, 2008).

When the disease gets worse ketoacidosis occurs which can lead to coma, limpness and ultimately death(Alberti and Zimmet 1998, Lin and Sun 2010). Sometimes the effects are not very severe or they might be missing and hyperglycemia may also be present a long time before diagnosis is done(Alberti and Zimmet 1998). The long-term effects of diabetes mellitus include progressive development of the specific complications of retinopathy with potential blindness, nephropathy that may lead to renal failure, and/or neuropathy with risk of foot ulcers, amputation, Charcot joints, and features of autonomic dysfunction, including sexual dysfunction. People with diabetes are at increased risk of cardiovascular, peripheral vascular, and cerebrovascular

Usually caused by autoimmune destruction of pancreatic beta cells, which produce and secrete insulin. By time symptoms develop, the damage to beta cells has progressed so far that insulin must be supplied exogenously, most often by injections. Reason for autoimmune attack is usually unknown, environmental toxins can be factors. People often have genetic susceptibility for disorder and are at increased risk of developing autoimmune diseases. Type-I usually develops during childhood and symptoms may appear abruptly. Classic symptoms are polyuria, polydipsia, and weakness. Acidosis due to excessive production of ketone bodies, ketoacidosis, is sometimes the first sign of diabetes. Blood test that detect antibodies to insulin, pancreatic islet cells, and pancreatic enzymes can confirm diagnosis and help predict development of

Diabetic ketoacidosis (DKA). If your body can't get enough glucose for fuel, it breaks down fat cells instead. This creates chemicals called ketones. Your liver releases the sugar it stores to help out. But your body can’t use it without insulin, so it builds up in your blood, along with the acidic ketones. This combination of extra glucose, dehydration, and acid buildup is known as "ketoacidosis" and can be life-threatening if not treated right away.

A sixteen-year-old boy was admitted through the emergency room presenting with difficulty breathing, abdominal pain, dry mouth, frequent urination, and fruity odor on breath. Initially, diabetic ketoacidosis comes to mind, but further labs are ordered to

Diabetic Ketoacidosis (DKA) is a disease state, most often seen in individuals with Type I Diabetes. While it most often results from uncontrolled insulin levels, young children can often present in diabetic ketoacidosis as the initial presentation of undiagnosed type I Diabetes. The major symptoms of Type I Diabetes, polydipsia, polyphagia, and polyuria, are often subtle and can be normal in growing children (Urden, Stacy & Lough, 2014; Wilson, 2012). Unless alert to the symptoms of Diabetes they can often be overlooked until severe enough to warrant immediate medical attention.

This paper will explore the history and hospital course of Mr. Z., a 23 year old Caucasian male who was admitted on October 11, 2016 to Massachusetts General Hospital for treatment of diabetic ketoacidosis (DKA) and new onset type 1 diabetes mellitus. DKA is an emergency situation that results in 100,000 hospitalizations in the US yearly, a 9% mortality rate, and treatments of reportedly 1 billion dollars per year (Katsilambros, Kanaka-Gantenbein, Liatis, Makrilakis, & Tentolouris, 2011). Presenting to the emergency room with DKA is the first manifestation of type 1 diabetes in 30% of cases (Katsilambros et al., 2011). This paper will examine Mr. Z.’s case presentation, pertinent medical history, diagnosis formulation, hospital management, intensive review of his medications, and discussion.

Healthy kidneys when presented with metabolic acidosis reabsorb HCO³ into the bloodstream and expel H+. The lungs try to decrease H+ by deep, rapid breathing (Kussmaul’s breathing) to blow off CO² (Capriotti & Frizell, 2016). Elimination of CO² pulls H+ out of the bloodstream. The patient’s body compensatory system is ineffectively slow remedying DKA that’s why IV sodium bicarbonate is crucial because it works as an alkalinizing agent by releasing bicarbonate ions.

d. The retention of water (H+) and the subsequent production of metabolic acidosis and Kussmaul breathing

Diabetes mellitus is a group of metabolic diseases. There are different kinds of diabetes mellitus, but an abnormal blood sugar level over an extended time always can be detected from patients who have this disease. Type one diabetes mellitus also known as insulin-dependent diabetes, patients with this type of diabetes have pancreatic beta cells destruction causing absolute lack of insulin with a tendency to ketoacidosis. It can occur at any age, but more commonly occurs in young people. Patients with acute onset of metabolic disorders symptoms need insulin injections to survive. This type of diabetes including immune-mediated and idiopathic two subtypes. Immune-mediated diabetes often has one or more autoantibodies present, for example, islet cell antibodies (ICA), insulin autoantibodies (IAA) and glutamic acid decarboxylase 65 (GAD65) antibodies.