karen.g wrote in message ...
>I thought it wasn't possible for t2's to get ketoacidosis???? Any t2's here that have had it? karen
AFAIK, T2 usually get NKH in preference to DKA. After reading a list of symptoms, I don't think
I could tell the difference though I think DKA are much more likely to fall into "frank coma"
while NKH just get sicker and sicker.
http://www.embbs.com/cr/dka/diagn.html
"History and Physical:
Patients with DKA usually present with complaint of fatigue, malaise, thirst, and polyuria.
Depending on the length of symptoms the patient may report weight loss. As the patient becomes
increasingly ill they may begin to vomit and complain of abdominal pain.
The physical signs of DKA can be variable. Most patients will have some degree of tachycardia, but
the blood pressure is often normal. Evidence of dehydration, such as loss of skin turgor, and dry
mucus membranes may be present. The patient may be febrile, and extreme elevations of temperature
should not be assumed to be the result of dehydration. Hypothermia may also be seen. . . . ."
There is a symptom called Kussmaul Breathing which seems to be specific to DKA but not NKH.,
http://www.hyperdictionary.com/medical/kussmaul+breathing
"Definition: The rapid, deep, and labored breathing of people who have ketoacidosis or who are in a
diabetic coma. Kussmaul breathing is named for Adolph Kussmaul, the 19th century German doctor who
first noted it. Also called "air hunger."
http://www.embbs.com/cr/dka/treat.html
"History and Physical:
NKH is a slowly progressive disease and it is not uncommon to have 3-10 day history of increasing
thirst, polyuria, and malaise. Courses of up to three weeks have been described. Symptoms of an
underlying infection may be present, but in some cases there is little history and the clinician
must consider this diagnosis in the elderly obtunded patient.
Patients usually have evidence of dehydration such as dry mucus membranes, tachycardia, poor skin
turgor, and sometimes a low grade fever. The blood pressure is usually well preserved unless there
is severe dehydration or infection. Respiratory symptoms are usually absent unless the patient has
pneumonia. Central nervous system dysfunction is relatively common in patients with NKH. Lethargy
and disorientation are common, but frank coma is rare. Any area within the brain can be affected,
and while focal neurologic findings are uncommon in DKA, they are fairly common in patients with
NKH. Seizures may be present in up to one-fourth of patients and can be focal or generalized.
Fortunately, cerebral edema is very rare in patients with NKH.
. . ."
febrile: having a fever, feverish polyuria: Passage of large volume of urine in a given period
tachycardia: racing heart, rapid heart rate obtunded: made less intense; dulled or deadened. focal
neurologic findings: ? ? ? ?
Regards
Old Al