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Stop watching at 2:30

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Learn Acid Base: Understanding Acidosis and Hyperkalemia

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Stop watching at 11:04

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MedCram - Medical Lectures Explained CLEARLY

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Diabetic Ketoacidosis (DKA) Explained Clearly - Diabetes Complications

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So patients can present with hypokalemia, normal serum potassium, or hyperkalemia... this two-paragraph blurb sums it up!

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So patients can present with hypokalemia, normal serum potassium, or hyperkalemia... this two-paragraph blurb sums it up!

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Glucosuria leads to osmotic diuresis, dehydration and hyperosmolarity. Severe dehydration, if not properly compensated, may lead to impaired renal function. Hyperglycemia, osmotic diuresis, serum hyperosmolarity, and metabolic acidosis result in severe electrolyte disturbances. The most characteristic disturbance is total body potassium loss. This loss is not mirrored in serum potassium levels, which may be low, within the reference range, or even high.

Potassium loss is caused by a shift of potassium from the intracellular to the extracellular space in an exchange with hydrogen ions that accumulate extracellularly in acidosis. Much of the shifted extracellular potassium is lost in urine because of osmotic diuresis.

Patients with initial hypokalemia are considered to have severe and serious total body potassium depletion. High serum osmolarity also drives water from intracellular to extracellular space, causing dilutional hyponatremia. Sodium also is lost in the urine during the osmotic diuresis.

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What causes potassium and sodium loss in diabetic ketoacidosis (DKA)?

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Glucosuria leads to osmotic diuresis, dehydration and hyperosmolarity. Severe dehydration, if not properly compensated, may lead to impaired renal function. Hyperglycemia, osmotic diuresis, serum hyperosmolarity, and metabolic acidosis result in severe electrolyte disturbances. The most characteristic disturbance is total body potassium loss.

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Kussmaul Breathing in Diabetic Ketoacidosis

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Stop watching at 2:00

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Hyperosmolar Hyperglycemic State, Diabetic HHS vs DKA, Animation

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HHS Goals and Interventions

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Note that fluid replacement should take place FIRST prior to insulin administration, and the video does not address this.

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Acute complications of diabetes - Hyperosmolar hyperglycemic nonketotic state | Khan Academy