A 45 year old male , known case of diabetes mellitus from last 15 years ,presents with Diabetic ketoacidosis . What shall be the initial line of management?
Diabetic ketoacidosis (DKA) is a problem that affects people with diabetes . It occurs when the body stas breaking down fat at a rate that is much too fast. The liver processes the fat into a fuel called ketones, which causes the blood to become acidic. Initial management is - 0.9% saline Treatment of choice - Insulin drip The use of 3% saline is not indicated because the patient has no neurologic deficits * Intracellular potassium shift out of cells in acidosis and cause a normal or even elevated potassium level but with improvement in the acidosis, it rapidly falls. (Insulin shifts potassium into intracellular compament thus resulting in fall of serum Potassium levels) Therefore, potassium repletion is critical.
3 % saline
5% dextrose
0.9 % saline
Colloids
DNB 2018