USMLE/COMLEX - Step 2 - Type 1 Diabetes Mellitus

USMLE/COMLEX - Step 2 - Type 1 Diabetes Mellitus Type 1 Diabetes Mellitus leads to an absolute insulin deficiency, causing hyperglycemia. In DKA, this leads to dehydration, electrolyte imbalances, and ketone production. The accumulation of ketones leads to acidosis and impaired cellular function. It can result in organ failure and death if left untreated. Kussmaul breathing Fruity-smelling breath Confusion or decreased level of consciousness Abdominal pain Nausea and vomiting Hypotension Tachycardia Hyperventilation Altered mental status Hyperglycemia Acidosis Electrolyte imbalances Presence of ketones in urine or blood Blood glucose test Arterial blood gas Serum electrolyte test Urinalysis Serum ketones test Complete blood count Serum amylase and lipase test The treatment of DKA is complex and requires a multidisciplinary approach involving healthcare professionals. Early recognition and treatment of DKA are essential to prevent severe complications and improve outcomes. Management steps include: 1. Fluid replacement with intravenous fluids 2. Insulin therapy through an intravenous line 3. Electrolyte replacement and monitoring of potassium, sodium, and bicarbonate levels 4. Treatment of underlying infection or trigger 5. Continuous monitoring of vital signs, blood glucose, electrolyte levels, and acid-base balance 6. Correction of acidosis with bicarbonate if severe