Podcast
Questions and Answers
Which of the following is a main clinical feature of Diabetic Ketoacidosis (DKA)?
Which of the following is a main clinical feature of Diabetic Ketoacidosis (DKA)?
- Hypoglycemia
- Hypokalemia
- Hypernatremia
- Hyperglycemia (correct)
What is the main cause of DKA?
What is the main cause of DKA?
- Excessive insulin production
- High carbohydrate intake
- Low protein consumption
- Absence or inadequate amount of insulin (correct)
What is the process that leads to dehydration and marked electrolyte loss in DKA?
What is the process that leads to dehydration and marked electrolyte loss in DKA?
- Antidiuretic hormone release
- Aldosterone deficiency
- Renal hypoperfusion
- Osmotic diuresis (correct)
What effect does insulin deficiency have on fat breakdown?
What effect does insulin deficiency have on fat breakdown?
What is the primary consequence of increased gluconeogenesis in DKA?
What is the primary consequence of increased gluconeogenesis in DKA?
What are ketone bodies produced from?
What are ketone bodies produced from?
What is the effect of ketone bodies accumulation in the circulation due to lack of insulin?
What is the effect of ketone bodies accumulation in the circulation due to lack of insulin?
What is the estimated maximum water loss in severe DKA over a 24-hour period?
What is the estimated maximum water loss in severe DKA over a 24-hour period?
What is a characteristic feature of osmotic diuresis in DKA?
What is a characteristic feature of osmotic diuresis in DKA?
What is the impact of insulin deficiency on glucose metabolism in cells?
What is the impact of insulin deficiency on glucose metabolism in cells?
What is the main reason that patients with HHS do not have the ketosis-related gastrointestinal symptoms?
What is the main reason that patients with HHS do not have the ketosis-related gastrointestinal symptoms?
What is the primary approach to the treatment of HHS?
What is the primary approach to the treatment of HHS?
Why is close monitoring of volume and electrolyte status important in the treatment of HHS?
Why is close monitoring of volume and electrolyte status important in the treatment of HHS?
When is potassium added to IV fluids in the treatment of HHS?
When is potassium added to IV fluids in the treatment of HHS?
Why is insulin usually given at a continuous low rate in the treatment of HHS?
Why is insulin usually given at a continuous low rate in the treatment of HHS?
What is the range of blood glucose level at which replacement IV fluids with dextrose are given in the treatment of HHS?
What is the range of blood glucose level at which replacement IV fluids with dextrose are given in the treatment of HHS?
How long may it take for neurologic symptoms to clear in the treatment of HHS?
How long may it take for neurologic symptoms to clear in the treatment of HHS?
After recovery from HHS, how can many patients control their diabetes?
After recovery from HHS, how can many patients control their diabetes?
What is important in prevention of recurrence of HHS?
What is important in prevention of recurrence of HHS?
What role does insulin play in the treatment of HHS compared to DKA?
What role does insulin play in the treatment of HHS compared to DKA?
Which of the following can lead to insulin resistance in diabetic ketoacidosis (DKA)?
Which of the following can lead to insulin resistance in diabetic ketoacidosis (DKA)?
How is Hyperglycemic Hyperosmolar Syndrome (HHS) distinguished from DKA?
How is Hyperglycemic Hyperosmolar Syndrome (HHS) distinguished from DKA?
What is a key factor contributing to Hyperglycemic Hyperosmolar Syndrome (HHS) in older adults?
What is a key factor contributing to Hyperglycemic Hyperosmolar Syndrome (HHS) in older adults?
What are the clinical manifestations of Diabetic Ketoacidosis (DKA)?
What are the clinical manifestations of Diabetic Ketoacidosis (DKA)?
How does insulin deficiency contribute to Diabetic Ketoacidosis (DKA)?
How does insulin deficiency contribute to Diabetic Ketoacidosis (DKA)?
What is the main effect of insulin deficiency in Hyperglycemic Hyperosmolar Syndrome (HHS)?
What is the main effect of insulin deficiency in Hyperglycemic Hyperosmolar Syndrome (HHS)?
How can prevention of DKA related to illness be managed?
How can prevention of DKA related to illness be managed?
What is the underlying cause that should be assessed after the acute phase of DKA?
What is the underlying cause that should be assessed after the acute phase of DKA?
What is the result of persistent hyperglycemia in Hyperglycemic Hyperosmolar Syndrome (HHS)?
What is the result of persistent hyperglycemia in Hyperglycemic Hyperosmolar Syndrome (HHS)?
What is the metabolic disorder most often associated with Hyperglycemic Hyperosmolar Syndrome (HHS)?
What is the metabolic disorder most often associated with Hyperglycemic Hyperosmolar Syndrome (HHS)?
Study Notes
Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar Syndrome (HHS) Overview
- DKA can be caused by missed insulin doses, illness, or undiagnosed diabetes, and insulin deficiency can result from insufficient dosage or patient errors.
- Illness and infections can lead to insulin resistance, causing an increase in "stress" hormones that promote glucose production and interfere with insulin's effects.
- Prevention of DKA related to illness involves "sick day rules" for managing diabetes, including not eliminating insulin doses when experiencing nausea and vomiting and regularly monitoring blood glucose and urine ketones.
- After the acute phase of DKA, underlying causes, including psychological reasons for missing insulin doses, should be assessed, and patients may be referred for evaluation and counseling.
- Clinical manifestations of DKA include polyuria, polydipsia, fatigue, blurred vision, weakness, headache, orthostatic hypotension, hyperventilation, acetone breath, and varying mental status.
- HHS is a metabolic disorder most often associated with type 2 diabetes, resulting from a relative insulin deficiency initiated by an illness that raises the demand for insulin, leading to hyperosmolality and hyperglycemia with minimal or absent ketosis.
- The lack of effective insulin in HHS causes osmotic diuresis, resulting in losses of water and electrolytes, and persistent hyperglycemia causes osmotic diuresis, leading to hypernatremia and increased osmolarity.
- HHS often occurs in older adults with no known history of diabetes or type 2 diabetes, traced to an infection or precipitating event such as an acute illness or medication exacerbating hyperglycemia.
- HHS is distinguished from DKA by the absence of ketosis and acidosis, partly due to differences in insulin levels, as no insulin is present in DKA, promoting breakdown of stored glucose, protein, and fat, leading to ketone body production and ketoacidosis.
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Description
Test your knowledge about Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar Syndrome (HHS) with this informative quiz. Explore the causes, clinical manifestations, prevention, and management of these serious complications of diabetes.
