Categories: Endocrinology

Why does DKA initially get worse when you start treating it?

When you begin to treat DKA, it paradoxically appears to get worse on urinalysis before getting better.

WHY? Serum ketones will become more positive as keotacidosis is treated, because B-OH butyrate (not measured) and Acetoacetate (measured) will be converted to Acetone (measured, but not an acid)

References

1. Gosmanov, A. R., Gosmanova, E. O., & Dillard-Cannon, E. (2014). Management of adult diabetic ketoacidosis. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 7, 255–264. http://doi.org/10.2147/DMSO.S50516

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Dr. C Humphreys

Internal Medicine

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