Pathophysiology of Diabetic Ketoacidosis (DKA)

What is the primary mechanism leading to hyperglycemia in diabetic ketoacidosis (DKA)?

How does hypovolemia contribute to acute kidney injury (AKI) in patients with DKA?

Which metabolic change is characteristic of diabetic ketoacidosis?

What role does insulin play in regulating potassium levels in DKA?

Which of the following acids contribute to the metabolic acidosis observed in DKA?

What happens to potassium levels in the body during DKA, despite initial serum levels appearing normal?

Regarding the osmotic diuresis in DKA, which statement is true?

What is the relationship between hyperglycemia and electrolyte balance in DKA?

Diabetic Ketoacidosis (DKA) Overview

Primarily affects patients with type 1 diabetes.
Insulin deficiency leads to key metabolic disturbances.

Mechanism of DKA

Insulin deficiency causes reduced glucose uptake, leading to hyperglycemia.
Hyperglycemia results in osmotic diuresis, causing loss of fluid and electrolytes, leading to hypovolemia.
Sequence: Insulin deficiency → hyperglycemia → hyperosmolality → osmotic diuresis → hypovolemia.

Complications of Hypovolemia

Decreased renal blood flow can lead to acute kidney injury (AKI).
Possibility of developing hypovolemic shock due to severe fluid loss.

Metabolic Acidosis in DKA

Lipolysis is stimulated, resulting in increased free fatty acids and subsequent ketone production.
Acetoacetic acid and beta-hydroxybutyric acid are produced, contributing to metabolic acidosis.
Serum bicarbonate levels decrease due to buffering of acidic ketones, resulting in an elevated anion gap.

Potassium Imbalance

Hyperglycemic hyperosmolality causes potassium to shift from cells to the extracellular space.
Insulin deficiency prevents cellular potassium uptake, contributing to a total body potassium deficit.
Serum potassium levels may be normal or elevated, despite total potassium depletion.

Importance of Potassium Management

Rapid potassium uptake occurs with insulin therapy, risking hypokalemia in patients with total body potassium deficit.
Close monitoring and potential potassium replacement are crucial during treatment.

Explore the mechanisms and effects of diabetic ketoacidosis (DKA) primarily in type 1 diabetes patients. Learn how insulin deficiency leads to hyperglycemia and subsequent hypovolemia through osmotic diuresis. This quiz will deepen your understanding of the pathophysiological aspects of DKA.