Acute Complications in Diabetes Mellitus: Diabetic Ketoacidosis, Hyperosmolar Hyperglycaemic State and Hypoglycaemia

An endocrinology lecture on the acute complications of diabetes, divided into the hyperglycaemic complications - diabetic ketoacidosis and the hyperosmolar hyperglycaemic state - and the hypoglycaemic ones. It defines DKA as a state of absolute or relative insulin deficiency aggravated by hyperglycaemia, dehydration and acidosis with ketonuria and a low pH, gives its epidemiology, the fact that it accounts for over half of diabetes-related admissions in young type one patients, its precipitating factors, clinical features and diagnosis, and its management through fluid resuscitation, the insulin infusion in normal saline with the drop rate calculated, potassium replacement, the restricted use of 1.4% sodium bicarbonate for persistent hypotension with a low pH, the general measures including the nasogastric tube in the comatose patient, and identifying and treating the underlying cause.