The SimKit Podcast Piece of Cake: DKA/HHS Update Part II with George Willis
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Feb 18, 2025 Join George Willis, an endocrinology expert, as he unpacks the 2024 ADA consensus report on diabetic emergencies. They delve into revised diagnostic criteria for DKA and HHS, shedding light on new glucose testing methods and the vital role of beta hydroxybutyrate. Discover advancements in treatment protocols, including fluid administration and potassium management, while challenging old beliefs. Willis emphasizes the critical differences between DKA and HHS, the importance of patient education, and innovative approaches to diabetic emergencies.
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Diagnostic Criteria Updates
- The 2024 ADA guidelines for DKA/HHS offer valuable diagnostic tools.
- These updates clarify existing practices rather than revolutionizing them.
DKA Workup
- Obtain a VBG, chemistry panel, and beta-hydroxybutyrate if DKA is suspected.
- Use end-tidal CO2 as a quick DKA rule-out tool: >27 effectively excludes DKA.
Ketone Body Metabolism
- Beta-hydroxybutyrate is the predominant ketone body in DKA, converting to acetoacetate with insulin.
- Urine/serum ketone assays measure acetoacetate, potentially underestimating early DKA.