Today’s Morning Report is presented by Dr. Aldokhi!
AKA versus DKA
AKA | DKA |
– Alcoholic
– Underlying disease – Missed Etoh |
– Diabetic
– Underlying disease – Missed insulin |
Nausea , vomiting, abdominal pain | Nausea , vomiting, abdominal pain |
DIAGNOSIS
– Hx + Ex – High AG – Ketoneuria, ketonemia – ? Glucose |
DIAGNOSIS
– Hx + Ex – pH <7.3 – AG >12 – Glucose >250 – Ketoneuria, ketonemia |
Rx
– Thiamine 100 mg – IV Fluid – Glucose – Potassium – Mg – phosphorus |
Rx
– Insulin 0.1 /kg bolus then 0.1/kg/hr or intermittent rapid acting * – IV fluid – Potassium
|
IV fluid
– Dextrose – Saline |
IV fluid
– NS initially 1L/hr – If low Na continue NS – If normal or high Na start 0.45 NS |
Insulin in DKA
Type of Insulin |
Brand Name |
Generic Name |
Onset |
Peak |
Duration |
*Rapid-acting |
NovoLog | Insulin aspart | 15 minutes | 30 to 90 minutes | 3 to 5 hours |
Apidra | Insulin glulisine | 15 minutes | 30 to 90 minutes | 3 to 5 hours | |
Humalog | Insulin lispro | 15 minutes | 30 to 90 minutes | 3 to 5 hours |
The views expressed on this blog are the author's own and do not reflect the views of their employer. Please read our full disclaimer here. Any references to clinical cases refer to patients treated at a virtual hospital, Janus General Hospital.
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Jay Khadpe MD
Editor in Chief of "The Original Kings of County"
Assistant Professor of Emergency Medicine
Assistant Residency Director
SUNY Downstate / Kings County Hospital
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