Tuesday, September 23, 2008

Diabetic Ketoacidosis: Precipitants


1. Any major illness: like infections (eg. pneumonia), infarctions (eg. myocardial), ischemia (eg. gut).

2. New onset of DKA: caution if this is new onset in someone older than their teens - there may be another destructive pancreatic process which warrants investigation.

3. Prescribed drugs: may affect glucose metabolism like glucocorticoids, antipsychotic agents.

4. Non-prescribed drugs: Cocaine is an independent risk factor for DKA. (Endocrine Practice 2007 3, 1, :22-9).

5. Poor compliance with insulin regimen: think about eating disorders like anorexia nervosa, other psychiatric conditions.

A great article from CMAJ on the Management of DKA: http://www.cmaj.ca/cgi/content/full/168/7/859

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