Lecture: Metabolic Complications of Diabetes

Describe the main acute metabolic complications of diabetes
Outline the pathophysiology and biochemical changes observed in diabetic ketoacidosis
Understand the consequences of relative insulin deficiency and the acute metabolic complications that can develop (HONK)
Outline the aims of treatment of diabetic ketoacidosis and HONK with reference to the biochemical and physiological changes that occur
Describe the symptoms of hypoglycaemia and be aware of the short and long term dangers of this metabolic complication

Diabetic Ketoacidosis

What is the epidemiology of DKA?
What is the definition of DKA?
What is the normal physiological response to hyperglycaemia (hormones)?
What is the relationship between DKA and the kidneys?
How does DKA develop?
What type of acidosis is created in DKA and what are the compensatory mechanisms (therefore serum values)?
What are the counter regulatory hormones in DKA and what are their actions?
Outline the progression of development of DKA (flowchart).
What is the treatment for DKA?
Why do we give additional dextrose to patients if their DKA is not resolving with first line management?
Describe and explain the potassium shifts and readings in DKA.

Hyperosmolar Hyperglycaemic State