Diabetes GP TALK June 2011 - Dr Nick Mann.pdf - Oxfordlearning ...

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Treatment of DKA • Similar to adults except- • Avoid fluid boluses • No insulin boluses • Avoid rapid falls in blood sugar • Correct dehydration over 24hr • Monitor Glasgow coma score hrly • Avoid anticoagulation unless in ITU • No antibiotics • Avoid NaHCo3 • Halve insulin in HONK
Management •Fluid management •INSULIN : Once rehydration fluids and potassium are running, blood glucose will already be falling. However, insulin is essential to switch off ketogenesis and reverse the acidosis. Continuous low-dose intravenous infusion is the preferred method There is no need for an initial bolus. Make up a solution of 1 unit per ml. of human soluble insulin (e.g. Actrapid or Novorapid) using a syringe pump. The solution should then run at 0.1 unit/kg/hour
Page 1 and 2: Prompt diagnosis of diabetes
Page 3 and 4: Less common presenting features •
Page 5 and 6: What to do
Page 7 and 8: Plan for DKA • Urgent hospital tr
Page 9 and 10: Well child- models of care • Admi
Page 11 and 12: Acanthosis Nigricans
Page 13 and 14: Outcome of young Type 2 diabetes
Page 15 and 16: Risk Factors • Poor compliance
Page 17 and 18: Definition of ketoacidosis • Gluc
Page 19 and 20: Confirm the Diagnosis : History : p
Page 21: DKA How Common • 12 new children
Page 25 and 26: Fingerprick ketone testing

Diabetes GP TALK June 2011 - Dr Nick Mann.pdf - Oxfordlearning ...

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