73. Diabetic Ketoacidosis

This podcast episode centers on diabetic ketoacidosis (DKA), its causes, and proper management in clinical settings. The hosts emphasize that DKA management requires identifying and addressing the underlying cause, not just treating symptoms. They introduce a mnemonic, the "five I's" (infection, ischemia, inflammation, intoxication, insulin deficiency), to aid in diagnosing DKA's causes. The discussion covers the metabolic processes leading to ketone production, differentiating between DKA, hyperglycemic hyperosmolar state (HHS), and euglycemic DKA, which is increasingly prevalent due to SGLT2 inhibitors. They stress the importance of monitoring electrolytes, fluid balance, and acid-base status, advocating for frequent lab checks and caution against overcorrection. The hosts also explore the potential for using continuous glucose monitors in hospitalized patients and transitioning to subcutaneous insulin in certain cases.