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Pathophysiology of Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar Syndrome (HHS)
Absolute Insulin deficit:
 - Type I DM:
Ketoacidosis (DKA ... HHS) Absolute Insulin ... Type I DM: No insulin ... food binges, etc Hyperglycemia ... Polydipsia #dka
Pathogenesis and Pathophysiology of Diabetic Ketoacidosis (DKA)

DKA is a result of an absolute or relative insulin
Ketoacidosis (DKA ... ) DKA is a result ... depletion and hyperglycemia ... In DKA, the normal ... abnormalities, including hyperglycemia
There are similarities and differences between these 3 conditions which all carry treatment implications. Each mimic
easily outweighs Insulin ... also present with Hypoglycemia ... you risk causing Hypoglycemia ... DKA is essentially ... ketoacidosis, Hyperglycemia
Hypoglycemia - Evaluation Algorithm
Interpreting Hypoglycemia Labs - the patient must be hypoglycemic at the time of
- Is there an insulin-like ... → Non-insulin/lGF-mediated ... Insulin - Is it ... insulin? ... → Exogenous Insulin
Hyperkalemia - Diagnosis and Management - GrepMed Handbook

S/Sx: Most pts asymptomatic. Weakness, cramping, nausea, paresthesias, palpitations,
transfusions), ↓insulin ... (DM, DKA, octreotide ... Treatments: • Insulin ... Give D50 before insulin ... Monitor hypoglycemia
Hypoglycemia Workup and Differential Diagnosis
Workup:
 • Sulfonylurea Labs
 • Anti-lnsulin Ab - Insulin Autoimmune Syndrome
 •
Hypoglycemia Workup ... Ab - Insulin Autoimmune ... demand causes hypoglycemia ... fast to trigger hypoglycemic ... Medicine @SCVMCMed #Hypoglycemia
Hypoglycemia Differential Diagnosis and Management Algorithm

Features of hypoglycemia:
 • Neurogenic: Tremor, Palpitations, Anxiety, Arousal, Sweating, Hunger,
Hypoglycemia Differential ... Features of hypoglycemia ... labs during a hypoglycemic ... episode: • Insulin ... • Glucose • Insulin
Differential Diagnosis of Hypoglycemia
Evaluation of Hypoglycemia
Patients with known diabetes who are not systemically ill and can
Differential Diagnosis of Hypoglycemia ... Evaluation of Hypoglycemia ... Other studies: insulin ... C-peptide, pro-insulin ... cortisol, B-OH, insulin
Pathophysiology and Effects of Insulin Deficiency

#Insulin #Deficiency #DKA #Ketoacidosis #Diabetes #Pathophysiology #Endocrinology
and Effects of Insulin ... Deficiency #Insulin ... #Deficiency #DKA
SGLT2 Inhibitors and Euglycemic DKA

Risk factors for euglycemic DKA in those on an SGLT2i include:
 •
and Euglycemic DKA ... for euglycemic DKA ... • Increased insulin ... and surgery) • Insulin ... SGLT2 #Euglycemic #DKA