2. Definition L ab T reatment C omplications P athophysiology S igns and S ymptoms E tiology D iagnosis contents

4. DKA is a life - threatening comp DKA is a life - threatening complication in Pt. with untreated DM (chronic high blood sugar or hyperglycemia). DKA occurs mostly in type 1 DM DKA is less common in type 2 DM, but it may occur in situations of physiologic stress . Pts . with new undiagnosed Type 1 DM frequently present to hospitals with DKA Definition

6. 1 . Hyperglycemia : gluconeogenesis, glycogenolysis ,↓glucose uptake into cell (underutilization) 2. Ketosis : lipolysis, ketogenesis , ↓ Peripheral tissue uptake ketone -- )ketonemia 3 . Hypertriglyceridemia : ↑free fatty acid 4. Osmotic diuresis : hyperglycemia -- ) renal loss glucose, Na & K -- )electrolyte imbalance 5 . Volume depletion : hyperglycemia, glucosuria & osmotic diuresis -- )dehydration Pathophysiology

8. การตรวจทางห้องปฏิบัติการเบื้องต้น 1 . Glucose & ketone in serum & urine 2 . Serum electrolyte, BUN, Cr, Ca, PO4 3 . Blood gas : capillary or arterial blood gas 4 . EKG : hypo / hyperkalemia 5 . CBC UA Lab

9. Serum glucose ) 300 mg / dl Acidosis : serum HCO3 < 15 mEq/ml or pH < 7.25 severity of DKA Mild : HCO3 > 15-18 mq / L & pH > 7.3 Moderate : HCO3 10-15 mq / L & pH 7.1-7.3 Severe : HCO3 < 10mq / L & pH<7.1 Ketone : positive ketone in urine and / or ser u m Diagnosis