The Curbsiders Internal Medicine Podcast REBOOT #25 Master Hyperglycemia and DKA
20 snips
Jul 4, 2022 AI Snips
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Episode notes
Fundamental Type 1 vs Type 2 Distinction
- Type 1 diabetes is autoimmune beta-cell destruction causing absolute insulin deficiency.
- Type 2 diabetes is insulin resistance often progressing to beta-cell failure over years.
DKA Is Cellular Starvation, Not Just High Sugar
- DKA stems from cellular starvation despite hyperglycemia because insulin absence prevents glucose uptake.
- The body shifts to free fatty acid metabolism producing ketones that acidify the blood.
A Little Insulin Prevents DKA
- Even high plasma glucose won't cause DKA if some insulin remains.
- A small amount of insulin prevents the metabolic 'gear shift' into ketone production.