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Suffering because of Diabetic KetoAcidosis - Case Study Example

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This case study highlights that the patient suffers from is Diabetic KetoAcidosis (DKA), with a secondary diagnosis as hypertension. At 49 years with a history of cigarette smoking and alcohol consumption, these are crucial clinical history findings that are important precipitating factors of this condition. …
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Suffering because of Diabetic KetoAcidosis

Thi study stresses that insulin deficiency as seen in type 1 DM compels the body to breakdown amino acids and triglycerides as opposed to glucose for energy production. Due to high breakdown of glyceride and amino acids, the levels of serum free fatty acids and glycerol goes abnormally leading to high level of uncontrolled lipolysis. The Free Fatty Acids (FFA) rises substantially in the blood ; meanwhile, muscles lysis goes up. Due to production of acetoacetic acids and hydroxybutyric acids, both of which are strong organic acids increases leading to metabolic acidosis. Metabolic acidosis is one of the classical symptoms of DKA during the initial stage. Because of increased metabolic acidosis, the patients physiologic compensation takes over. In order to restore normal pH, there is Kausmal respiration that attempt to increase the expiration. Many patients will present with acetone-breathe. Hyperglycemia arises due to insulin insufficiency leading to high sugar levels in the blood and osmotic diuresis that leads to loss of urinary function. This is a striking similarity with the case study presented. In addition, the urinary excretion of ketones causes increased loss of sodium, potassium and water is lost at large amounts leading to reduced urinary excretion as seen in the patient. As a result of increased loss of electrolytes, potassium often migrates into extracellular component leading to increased potassium levels, often driven back to intracellular by insulin therapy. In order to diagnose DKA, first the patient history and physical assessment helps in identifying which laboratories test to be done. Clinical diagnosis depends on three key laboratory findings; the arterial blood pH normally less than 7.30 with an anion gap of more than 12. Secondly, serum ketones levels are an important diagnostic measurement. The presence of serum ketones and urine ketones indicate definitive diagnosis. ... Read More
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