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What is the protocol for DKA?

What is the protocol for DKA?

A mix of 24 units of regular insulin in 60 mL of isotonic sodium chloride solution usually is infused at a rate of 15 mL/h (6 U/h) until the blood glucose level drops to less than 180 mg/dL; the rate of infusion then decreases to 5-7.5 mL/h (2-3 U/h) until the ketoacidotic state abates.

What is the first step in DKA management?

The initial priority in the treatment of diabetic ketoacidosis is the restoration of extra-cellular fluid volume through the intravenous administration of a normal saline (0.9 percent sodium chloride) solution.

When do you give Bicarb to DKA?

Consensus guidelines for the management of DKA recommended administering sodium bicarbonate to DKA patients who present with an initial blood gas pH of < 7.0. That recommendation was updated and changed in 2009 to limit sodium bicarbonate use to DKA patients with blood gas pH of < 6.9.

Why is bicarbonate not indicated in DKA?

Acid–base balance, fluids and electrolytes. Acidosis in DKA is due to the overproduction of β-hydroxybutyric acid and acetoacetic acid. At physiological pH, these 2 ketoacids dissociate completely, and the excess hydrogen ions bind the bicarbonate, resulting in decreased serum bicarbonate levels.

When should potassium be given in DKA?

Potassium repletion should commence once the serum potassium falls below 5.3 mEq/L if patients have normal renal function. Twenty to 30 mEq of potassium may be supplemented to each liter of fluids. Patients with severe hypokalemia may require more potassium during the first hour of insulin treatment.

What is the difference between the Somogyi effect and dawn phenomenon?

The Somogyi phenomenon states that early morning hyperglycemia occurs due to a rebound effect from late-night hypoglycemia. The dawn phenomenon, however, does not include hypoglycemic episodes to be a factor.

When do you give nahco3 in DKA?

What is the maximum level of sugar?

Then you’ll drink the sugary liquid, and have your blood sugar tested 1 hour later, 2 hours later, and possibly 3 hours later. At the 2-hour mark, a normal blood sugar is considered to be 140 mg/dL or lower, while 140-199 mg/dL indicates prediabetes and 200 mg/dL or higher indicates diabetes.