Diabetic ketoacidosis more common in type 1 than in type 2...

Diabetic Ketoacidosis More common in type 1 than in type 2 diabetes Caused by a lack of insulin May result in "fruity"-smelling breath Results from too much insulin Blood pH less than 7.3 Results from hypoglycemia Glucose available but body cannot use it Increased ketone formation

Transcript

00:01 Okay, this question here says a 34 year old woman with diabetes is admitted to the emergency room in a stuporous state her skin is flushed and warm her breath has a sweet odor her pulse is rapid and weak and her respirations are rapid and deep her initial laboratory test indicates a blood sugar of so the blood sugar is 320 that is actually increased.

00:29 Okay, then it says that the serum bicarbonate levels are 12 the normal values range from 24 to 27.

00:38 So it is low it says that the ph is 7 .1 the normal levels are from 7 .35 to 7 .45.

00:48 So this is also low and it says what is the most likely cause of her lower ph and bicarbonate levels? how would you account for her rapid and deep respirations? and how would you explain her warm flushed skin and stuporous mental state? in this case this patient has most likely a condition called dka that stands for diabetic ketoacidosis.

01:12 In this case as you can see here well in general the pathophysiology of this condition involves that there is a depletion of a molecule called oxaloacetate.

01:26 Okay, that is essential for a process of gluconeogenesis now a this patient most likely has type 2 diabetes.

01:38 Okay, and in type 2 diabetes your cells are not going to be responsive to to insulin and insulin is a hormone that is essential for expressing glucose transported from the cell on the cell's surface so your glucose molecule here is in the blood but if insulin cannot or insulin receptor does not respond to insulin then these receptors are not going to be expressed and hence your glucose is going to remain in the blood and it is going to cause hyperglycemia but your liver specifically is going to think that you are kind of fasting because your cells are not getting enough energy or are not producing energy because glucose that is the main fuel for energy cannot enter the cells so your liver is going to think that you actually that your body actually lacks glucose so it is going to start this process of gluconeogenesis it is going to start gluconeogenesis.

02:35 It is going to use all the oxaloacetate and also it is going to start the process of beta oxidation or oxidation of fats practically.

02:45 It produces acetyl -coa and other molecules...

Question

Diabetic Ketoacidosis More common in type 1 than in type 2 diabetes Caused by a lack of insulin May result in "fruity"-smelling breath Results from too much insulin Blood pH less than 7.3 Results from hypoglycemia Glucose available but body cannot use it Increased ketone formation

Please give Ace some feedback