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 |
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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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