H I P ER

G L l K E M I A
NAJMA ZAHIRA
2208260125
 Diabetic ketoacidosis
(DKA)
Diabetic ketoacidosis (DKA) is a state of
metabolic decompensation characterized
by the triad of hyperglycemia, acidosis and
ketosis, mainly caused by absolute or
relative insulin deficiency.
 Etiology
1
The most frequent cause of
DKA is infection. Other
precipitating factors include
serious illness
(cerebrovascular accident,
acute myocardial infarction,
pancreatitis), alcohol abuse,
trauma, and drugs.
Risk factor
Suffering from type 1 diabetes
Frequently missing insulin doses
Cocaine and alcohol abuse,
trauma
Use of certain medications
(corticosteroids, thiazides,
pentamidine)
Clinical manifestations
Severe dehydration
Hypotension and shock
Nausea, vomiting
Polyuria and polyphagia
Weakness and fatigue
Confusion
Experiencing increased laterality
Experiencing hemisensory deficits, hemiparesis, and aphasia
Experiencing a coma
Supporting investigation

Glucose
Sodium
Potassium
Bicarbonate
Complete blood cells
Blood Gas Analysis
Ketones
β-hydroxybutyrate
Urinalysis
Osmolality
Governance
Fluid
Insulin
Potassium
HNK
 What is HNK?
HNK is characterized by severe non ketotic or ketotic
hyperglycemia and mild acidosis. In advanced cases, coma may
occur. Non-ketotic hyperosmolar hyperglycemic coma is a
syndrome characterized by severe hyperglycemia, hyperosmolar,
severe dehydration without ketoacidosis accompanied by
decreased consciousness.
 Etiology Risk Factor Clinical manifest

> 60 years the patient is apathetic to

reduced electrolyte comatose
fluid people with kidney or signs of severe dehydration are

stress cardiovascular found

no acetone odor from breathing
disease no sign of breathing kusmaul
Supporting Examination

blood glucose level > 600

mg/dL
serum osmolality 350mOsm/kg
reaction of ketones with
weakly positive nitroprusid
Administration
NaCl 1000ml/hr
Glucose 5% when blood glucose at 200-250mg/dL
Insulin
Kalium
Avoid secondary infection
 Reference :
Aman, A. M. (2018) Hiperglikemia: Dalam Praktik Sehari - Hari. Makassar: Universitas Hasanuddin.
Available at: http://digilib.unhas.ac.id/uploaded_files/temporary/DigitalCollection/ZmV
hNGM2ODI3Y2U1MjIyMDRkMzg0NDY4ZDBhMTA1MDQ5M2JiOW FjMQ==.pdf
Al-Saeed, H.A., Constantino, I.M., Molyneaux. L., D‟Souza, M. Gisler, L.F., et al. 2016. An Inverse
Relationship Between Age of Type 2 Diabetes Onset and Complication Risk and Mortality: The
Impact of Youth-Onset Type 2 Diabetes. Diabetes Care Volume 39: 823-829.Al-Saeed, H.A.,
Constantino, I.M., Molyneaux. L., D‟Souza, M. Gisler, L.F., et al. 2016. An Inverse Relationship
Between Age of Type 2 Diabetes Onset and Complication Risk and Mortality: The Impact of Youth-
Onset Type 2 Diabetes. Diabetes Care Volume 39: 823-829.