Diabetic Ketoacidosis: Mechanism, Pathophysiology, Fluid, Insulin and Potassium Therapy

A medicine lecture on DKA as a state of absolute or relative insulin deficiency, with the laboratory definition at a blood glucose level above 250 mg/dl. It takes the mechanism and the pathophysiology of the hyperglycaemia to hyperosmolality to increased urination chain, the initiating and triggering factors from emotional stress to drugs, the clinical features and physical signs, and the diagnosis. Management follows through the general and specific measures, fluid therapy with normal saline and the calculated volume deficit, the standard low-dose regular insulin regimen in U-40 and U-100 concentrations, potassium therapy for the mild to moderate hypokalaemia, hourly glucose monitoring and the criteria for resolving DKA, and the complications from hypoglycaemia to overhydration and acute pulmonary oedema.