Diabetic Ketoacidosis (DKA) Explained Clearly - Diabetes Complications

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  • Опубликовано: 29 май 2024
  • Understand Diabetic Ketoacidosis (DKA) with this clear explanation from Dr. Seheult of www.medcram.com/?Y...
    This is video 1 of 2 on diabetic ketoacidosis (pathophysiology and signs of diabetic ketoacidosis / DKA):
    0:08 DKA stats
    0:47 DKA - cellular anatomy
    1:00 mitochondria
    1:48 beta-oxidation
    2:30 insulin function
    3:08 pyruvate
    3:19 diabetes mellitus type 1
    3:26 diabetes mellitus type 2
    4:48 ketone bodies (acetone, acetoacetate, b-hydroxybutyrate)
    6:09 carboxylic acid
    6:23 conjugate base (anion gap acidosis)
    7:38 beta-oxidation
    8:17 DKA review
    8:57 diabetic ketoacidosis - hyperkalemia
    9:37 diabetic ketoacidosis - dehydration
    9:50 osmotic diuresis
    10:10 dehydration
    10:27 diabetic ketoacidosis - potassium effects
    11:04 diabetic ketoacidosis - Cr elevation / renal failure
    11:30 anion gap metabolic acidosis
    12:09 measuring ketone bodies (serum ketones, b-hydroxybutyrate)
    Speaker: Roger Seheult, MD
    Clinical and Exam Preparation Instructor
    Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine.
    MedCram: Medical topics explained clearly including: Asthma, COPD, Acute Renal Failure, Mechanical Ventilation, Oxygen Hemoglobin Dissociation Curve, Hypertension, Shock, Diabetic Ketoacidosis (DKA), Medical Acid Base, VQ Mismatch, Hyponatremia, Liver Function Tests, Pulmonary Function Tests (PFTs), Adrenal Gland, Pneumonia Treatment, internal medicine, usmle prep, dka, and many others. New topics are often added weekly- please subscribe to help support MedCram and become notified when new videos have been uploaded.
    Subscribe: ruclips.net/user/subscription_...
    Recommended Audience: Health care professionals and medical students: including physicians, nurse practitioners, physician assistants, nurses, respiratory therapists, EMT and paramedics, and many others. Review for USMLE, MCAT, PANCE, NCLEX, NAPLEX, NDBE, RN, RT, MD, DO, PA, NP school and board examinations.
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    Produced by Kyle Allred PA-C
    Please note: MedCram medical videos, medical lectures, medical illustrations, and medical animations are for medical education and exam preparation purposes, and not intended to replace recommendations by your health care provider.

Комментарии • 318

  • @Tombzy
    @Tombzy 3 года назад +113

    I almost died from dka 18 years ago. I was a newly diagnosed type 1 and was still learning how to manage my diabetes. I went to work and forgot my insulin and tester, I figured I could get through the day without it. At the end of my shift I started to feel nauseated and like I was getting the flu. I had a 1.5 hour commute home and during that time I was pulling over to vomit all the way home and felt like death. I finally made it home and immediately crawled into bed because I felt so awful. I didn't check sugars because I was so out of it. I passed out and went into a comatose state. Thank God my girlfriend came over a few hours later and found me. I don't remember anything but she told me I was basically dead, barely breathing and ghostly white. Thanks to great doctors and nurses about one week later I was well enough to go home from the hospital, with no lasting damage.

  • @wearethe27
    @wearethe27 2 года назад +183

    *My daughter drinks lots of water and urinates with the same rate, there are no other symptoms to show if those have anything to do with diabetes. This is a good information that I have gone through **Diabets.Care** She is 2 years 9 months, hale and healthy, have not done any blood test. But I am not certain if one can get diabetes at such a tender age. Please I will like to know more on that*

  • @peybak
    @peybak 4 года назад +158

    Great lecture. In case anyone is curious, the reason why the Acetyl COA (ACA) made from B-oxidation doesn't go through the Krebs cycle here is because in diabetes there is also a lack of Oxaloacetate (OAA). OAA gets depleted for gluconeogenesis to provide glucose for the brain. (In Krebs Cycle, the first step is combination of ACA and OAA to make citrate.)

  • @HatchetMouth
    @HatchetMouth 7 лет назад +37

    As an individual with type 1 Diabetes for 9 years. This has helped me see what DKA is more than any doctor I've had could explain. Thank you.

  • @AYang-gt7dd
    @AYang-gt7dd 8 лет назад +30

    MEDCRAM, aka Dr. S, I have listened to almost all your lectures as I was preparing for my nclex-rn exam and I was able to understand the concepts so much better having listened to your explanations and then re-reading the books again. I only wish I had done this sooner so that I could've taken this exam a lot sooner instead of rescheduling it every time I had a panic attack. To whoever out there that is listening to Dr. S's videos, if you are hoping to learn from him, then you are at the right place. Do your readings, then listen to him explain it, then go back and review your notes again and again. That's what I did as I was studying. The biggest hurdle is to not panic when you're studying, just keep studying and reviewing, and review these concepts over and over again if needed, and you'll be prepared when the exam day comes around. Keep the faith. You'll pass. I have just taken my nclex-rn and passed with 75 questions and Dr. S was a big part in helping me achieved this dream. Thank you for making these videos. They are a tremendous help!!

  • @fiddlefigtree3363
    @fiddlefigtree3363 2 года назад +3

    nursing student here. I like being explained to me thoroughly instead of just looking at signs and symptoms . it help me understand the topic more if I see the overall picture of whats going on and this helped me so much! well explained! instantly Subscribed! thankyou

  • @zumacon
    @zumacon 8 лет назад +12

    I am just preparing for the physiology class that I am signed up for in the fall. I've read several texts but this lecture really goes through it much more clearly. Dr. Seheult tone is right as well, he seems relaxed with the subject and speaking in a conversational tone as if he were tutoring an individual. I've watched several of the MedCram videos over and over. Best way to learn. Thank you.

  • @AkSonya1010
    @AkSonya1010 10 лет назад +4

    Thank you for a clear explanation. My spouse is currently in the hospital with this issue. Thank you for helping me understand what is happening and why. It made everything that the Dr tried to explain really fast understandable.

  • @julieannantis2525
    @julieannantis2525 10 лет назад +6

    Another nursing student here who found this very helpful. Thank you.

  • @pricklypear1111
    @pricklypear1111 9 лет назад +24

    I'm a 4th year med student studying for Step 2 CK and this helped a lot! I like the organic chem structures too....gave me tons of nostalgia!!

    • @Medcram
      @Medcram  9 лет назад

      Sim Simma Good to hear- thank you for the feedback

  • @Bullzmilk123
    @Bullzmilk123 4 года назад +8

    Every time I ask “why” in my head, you answer lol I love it thanks 😁

  • @Wilsonbuildsthings
    @Wilsonbuildsthings 7 лет назад +32

    Not even in medical school yet but I still enjoy all this stuff! Thanks for helping me satisfy my knowledge cravings!

    • @je6874
      @je6874 5 лет назад

      Wilson Lei you’ll do well!

  • @mattwarry1894
    @mattwarry1894 7 лет назад +8

    Mate, awesome vid, I like how intricately you explain DKA yet still make it relatively easy to comprehend, love it!

  • @1beckedorf
    @1beckedorf 2 года назад +1

    As a type1, I Had three episodes of DKA over a 20 year period.
    Hospital saline drip helped me out on one occasion, the other occasions I drank small quantities of water frequently, and administered more insulin
    up and above the requirements as per the recommendations, Urine Test strips are effective.
    It’s the worst Flu type symptoms, and a step closer to oblivion if not managed correctly.

  • @jeslynn1144
    @jeslynn1144 6 лет назад

    Very good info, and yes.. who gives thumbs DOWN? My 6 yr old Son had tonsils and adenoids removed. Been a challenging few days. These vids help immensely in keeping ketones, which were spiking, down. Choosing the perfect diet, then maintaining a consistent neutral while also making sure to administer a minimum of " 1 unit incilin/carb every 3 hours". Was no walk in the park. Especially when your child's miserable in pain, running a fever and not wanting to eat or drink. Day 5 and looks like we're on our way to a speedy recovery.

  • @dnuts559
    @dnuts559 8 лет назад +38

    wow made no sense to me in class but you made it so simple love it.

    • @Medcram
      @Medcram  8 лет назад

      +ORACIO CALVILLO Thanks for the comment, glad the video cleared some things up

  • @lisatowe778
    @lisatowe778 6 лет назад +25

    Excellent video! I am an RN but I like to know the how and why of everything in life, sometimes it is just too much information but you have a way of sorting out the tangle and presenting it with the how and why, love that. Thank you!

    • @afrprincess07
      @afrprincess07 6 лет назад +1

      Lisa Towe Likewise. I also like to know the “why” behind everything in life!

  • @jim2980
    @jim2980 10 лет назад +3

    Glad to hear your lecture again on youtube! Glad to see you are still doing these lectures. I'm recommending them to all my internal med colleagues here in WA.

  • @hammypie
    @hammypie 8 лет назад +3

    I just found your channel, and I LOVE your videos. You are seriously helping so many people - for example I'm a home care nurse and the most I do is actually teaching to my patients, but I was never taught well in school and have to self study. So glad you have HF here!! it seems like everyone has HF and DM!

    • @Medcram
      @Medcram  8 лет назад +1

      hammypie Glad the videos have been helpful for your home care nursing work- thanks so much for the feedback

  • @emilygreen2436
    @emilygreen2436 5 лет назад +8

    This is so well done. I really really appreciate it, thank you.

  • @laughingkrikit
    @laughingkrikit 10 лет назад +4

    Thank you, this answered so many of my questions! I have a fourteen year-old child who has had type 1 for nine years, and he had a DKA episode this year. His first, and hopefully last.

  • @j0rdandavid
    @j0rdandavid 9 лет назад +2

    really clear and concise explanation! great review for PICU

  • @9q9v5w
    @9q9v5w 6 лет назад +1

    absolutley fabulous lecture it made analysing acid base peorlems easy

  • @hollymilam9257
    @hollymilam9257 5 лет назад +2

    This video was exactly what I was looking for. Fantastic.

  • @amandakimsey9013
    @amandakimsey9013 5 лет назад +5

    This helps a ton! Its been a while since I've had this in school. Thanks for the refresher!

    • @Medcram
      @Medcram  4 года назад

      Great to hear, thanks!

  • @foomphy
    @foomphy 10 лет назад +1

    Nursing student here-this was very helpful-thanks!

  • @jillyburt
    @jillyburt 6 лет назад +2

    Thank you for great, simple explanations.

  • @sjba11er
    @sjba11er 11 лет назад +2

    Dr. Seheult, it would be great if you could add at the end of your videos a small segment on treatment/therapy that would fall in line with the pathophysiology explained in the majority of the video. That would be really helpful for us medical students. Thanks!

  • @andilekheswa2192
    @andilekheswa2192 9 лет назад +4

    I wish you were my lecturer, I would ace all my exams, Thank you for this great video and all your other content!!!

    • @Medcram
      @Medcram  9 лет назад

      Andile Kheswa thank you for the feedback

  • @ianvincent845
    @ianvincent845 8 лет назад +2

    Watched several times to understand the process correctly (engineer not a medic!). Added a quite a few new words to my vocabulary too! I would be very interested to see a presentation explaining the flip side of this topic; hypoglycaemia.

  • @doctortsiurak
    @doctortsiurak 9 лет назад +2

    Lection is very interesting and easy for understanding!

  • @doctorshelp9944
    @doctorshelp9944 9 лет назад +1

    Beautifully explained in very simple way.Thank you very much.

    • @Medcram
      @Medcram  9 лет назад

      DR.JAGAT CHAUDHARY Thank you for the feedback

  • @tonychurch6829
    @tonychurch6829 3 года назад +2

    Great video, very clearly explained. Thanks!

  • @benpaul5330
    @benpaul5330 9 лет назад

    Awesome video! thank you very explaining the treatment because many people fail to recognize correct reasons we treat with insulin.

  • @Medcram
    @Medcram  7 лет назад +12

    See the whole series at www.medcram.com along with other top quality videos including reviews in pulmonary, cardiology, infectious disease, and hematology!

  • @anklbreakr88
    @anklbreakr88 10 лет назад +3

    Thank you! just had a pt in the ED present this way. You explaination was very helpful!

  • @arion45
    @arion45 10 лет назад

    Saw a pt today that I had to explain this to today and felt a little rusty. This filled in the gaps of knowledge. Thank you!

  • @tomtong9859
    @tomtong9859 11 лет назад +1

    another fantastic and brilliant lecture....its to perfection

  • @miriamadorno1939
    @miriamadorno1939 6 лет назад +2

    thank you for that wonderful explanation on DKA

  • @billd8346
    @billd8346 10 лет назад +1

    Terrific short lecture. Thanks.

  • @SilverGray33
    @SilverGray33 5 лет назад +2

    This was a great video. I would like to request if you can cover hypothyroidism vs hyperthyroidism

  • @TheDAT573
    @TheDAT573 10 лет назад +1

    Thank you for this video.
    I had terrible symptoms, being extremely thirsty, unsteady on my feet, a weird smell.
    My doctor, said I had diabetes and put me on Kombliglyze XR.

  • @jeangeraldgilles2984
    @jeangeraldgilles2984 5 лет назад +2

    I love this videos. Should the phosphate level be high prior to giving insulin for a patient with DKA? Phosphate is needed for glycolysis and there's a lack of insulin or inability of the cell to respond to insulin in DKA, therefore, phosphate can't go in the cell to help metabolize the glucose.

  • @knowledgeenrichment5740
    @knowledgeenrichment5740 6 лет назад +2

    Your explanation is really good 💜

  • @gribbles123
    @gribbles123 11 лет назад

    even for a nursing student (furthermore a mature one) it has been an insightful visual aid :) thank you and I have definitely subscribed.

  • @eugenias471
    @eugenias471 3 года назад

    amazing job!!! thank you so much. we need more of your work!!

  • @odayalhafdh
    @odayalhafdh 9 лет назад +2

    Nice lecture, very illustrative!!

  • @anklbreakr88
    @anklbreakr88 10 лет назад +1

    thank you for the excellent and concise explanation!

  • @grbgeslnger24
    @grbgeslnger24 5 лет назад +1

    Definitely a med student video. A bit advanced for me, but I love learning new things.

  • @kayaksta
    @kayaksta 10 лет назад +52

    who would dislike this video? this is for med students. if this is too advanced for you, then move along

    • @kyleocallaghan9185
      @kyleocallaghan9185 6 лет назад +3

      Ahaha get over yourself

    • @jbrock8849
      @jbrock8849 6 лет назад

      Shut up your fucking nerd

    • @AnotherBadyoga
      @AnotherBadyoga 6 лет назад +2

      I learn from these videos but I think they could be improved, the lapses where you have to watch him spell or draw out something is a time waste. But I agree, great info here.

    • @justinprendeville2678
      @justinprendeville2678 4 года назад

      he's going so slow

  • @maksoy69
    @maksoy69 10 лет назад +3

    eXELLENT EXPRESION. CONGRATULATIONS

  • @rdseheult
    @rdseheult 11 лет назад

    Congrats on your education. I did IM then Pul/CC as well. You'll never be bored.

  • @AyezaKhan20
    @AyezaKhan20 6 лет назад +1

    Mind blowing video.Thanks

  • @ExplorerDrlife
    @ExplorerDrlife Год назад +1

    Thanks alot it's very clear n good presentation ❤️

  • @sublingualsidekick
    @sublingualsidekick 10 лет назад +3

    I really enjoy your lectures. I've never felt so aware. Thank you so much! I'm a paramedic intern btw.
    Please do HHNK next! :)

    • @user-mz6ts4xn6i
      @user-mz6ts4xn6i 4 года назад

      not really relevant for a paramedic to understand this lvl of detail is it?

  • @dianaayonn
    @dianaayonn 8 лет назад

    Your videos help me a lot ! My instructor introduced them to us and since then I've been hooked lol

    • @Medcram
      @Medcram  8 лет назад

      +Diana Ayon Good to hear- thanks

  • @rkiff
    @rkiff 11 лет назад +1

    this is a fantastic explanation, thank you

  • @doyceh
    @doyceh 10 лет назад +2

    Very helpful in my studies. Thanks

  • @MedicEne
    @MedicEne 7 лет назад +1

    Fantastic lecture

  • @shavedmax
    @shavedmax 11 лет назад

    Excellent, concise, relevant.

  • @nellyhoffman6194
    @nellyhoffman6194 7 лет назад +2

    Great lecture :) thanks a lot MED CRAM

  • @budskirlee
    @budskirlee 9 лет назад +1

    Thank you for a simple and understandable explanation of DKA

    • @Medcram
      @Medcram  9 лет назад

      budskirlee thanks for the comment

  • @tnagan
    @tnagan 11 лет назад +2

    Thank you! I was wondering the same thing.

  • @user-uv5dv1hp7c
    @user-uv5dv1hp7c 4 года назад +2

    This is one of the best videos l have sown never!!!

    • @Medcram
      @Medcram  4 года назад

      Thank you for watching!

  • @rumit9946
    @rumit9946 11 лет назад

    Excellent. Thanks for putting this together.

  • @shellyfrombundy
    @shellyfrombundy 10 лет назад +2

    Thanks... this Nursing student appreciates the info :)

  • @rajeshmithun9455
    @rajeshmithun9455 3 года назад

    Nice & concise explanation

  • @kebirbenkaccem726
    @kebirbenkaccem726 4 года назад +1

    Dr roger ,do you ha ve any videos explaining diabetes 1 and 2?
    Thank you for magnificent enlightenment always...

  • @leo-rv5xl
    @leo-rv5xl 7 лет назад +1

    i nailed this dka ...thanks a lot..now i will play with this topic..

  • @MehMah83
    @MehMah83 10 лет назад +1

    Thanks so much for doing these videos!

  • @damienspillane7053
    @damienspillane7053 10 лет назад +2

    Legend. So amazingly well done.

  • @AmIRealYouTube
    @AmIRealYouTube 10 лет назад +1

    Good day! very, very helpful for my exam! Many thanks! P.S. What software did you use?

  • @bruinfnp1527
    @bruinfnp1527 10 лет назад +2

    Thank you so much! Very helpful :)

  • @minjungkim3144
    @minjungkim3144 8 лет назад

    Great!
    How does dehydration affect the level of Cr and total body K at 10:14 and 11:13?
    Can you explain that a bit more?

  • @macwinwinnyday9374
    @macwinwinnyday9374 7 лет назад +2

    sir would u pls xplain how osmotic diuresis leads to k depletion...
    that pt i cant understand..
    thk u!.

  • @laurenroach974
    @laurenroach974 10 лет назад

    Solid.... really cleared things up...
    -2nd yr med student

  • @prakashchavan4026
    @prakashchavan4026 5 лет назад +1

    Thank you very much Sir🙏

  • @geojor
    @geojor 9 лет назад +2

    thanks for this...

  • @84nonis
    @84nonis 11 лет назад +2

    Very well EXPLAINED!!!!!! Finally......

  • @dharmrajmaurya605
    @dharmrajmaurya605 6 лет назад +1

    great lecture

  • @debanjanbhattacharjee1098
    @debanjanbhattacharjee1098 8 лет назад +1

    very helpful lecture

  • @sarahscratch8485
    @sarahscratch8485 9 лет назад +2

    This is wonderful! Thanks for sharing this!! :)

    • @Medcram
      @Medcram  9 лет назад

      Sarah Lemire Thanks for your feedback- glad the video was helpful

  • @432Esh
    @432Esh 4 года назад +4

    I was just diagnosed in March and I got this like a week later, my sugar was 1094....

  • @KenDBerryMD
    @KenDBerryMD 6 лет назад +26

    Great video!

  • @dirkhuman760
    @dirkhuman760 Год назад

    What does a cell membrane look like? When was it seen? How was it found? What instrument was used? Can a SEM work without metal? What is an artifact?

  • @luisrank11
    @luisrank11 9 лет назад +1

    Wow!! very well explained!!!! Thank you!!

    • @Medcram
      @Medcram  9 лет назад

      luisrank11 Thanks for the feedback

  • @emmanuelobadoni3925
    @emmanuelobadoni3925 3 года назад +1

    Excellent 👍

  • @CantHaveTheMango
    @CantHaveTheMango 11 лет назад +1

    Thanks, John Tesh!

  • @juansarmiento2022
    @juansarmiento2022 9 лет назад

    Great Lecture

  • @fahrihusaini4007
    @fahrihusaini4007 3 года назад

    Last time i study biologi is like 5 years ago. And i still think that biologi is my favorite course.

  • @Arianna_justme
    @Arianna_justme 10 лет назад +1

    Great explanation..Thank You :)

  • @monkeyboy018
    @monkeyboy018 7 лет назад

    Is potassium also increased intravascularly due to the lack of insulin considering insulin is also involved in potassium transport or is it only due to the na/k transporter?

  • @madarasilva424
    @madarasilva424 2 года назад

    Great lecture !

  • @thanujaashani2048
    @thanujaashani2048 4 года назад

    I have question.
    Patient known case of DM type 2
    On sc Insulatard 16 units on Night and sc actrapid 10 units TDS.
    Suddenly noted after sc insulatard 16 units admission One hour later , glucose levels at blood 30.
    But no symptoms of DKA.
    Patient no polydipsia or poly uria..no fast breathing. He is totally well.
    After another hour later HGT 26
    After another Hour later 18
    Do we need to work out DKA ??

  • @googleplay9522
    @googleplay9522 5 лет назад

    Thanks for your great video. Ketogenic diet along with intermittent fasting is getting very popular. Can you please give us an analysis of this diet in relation to the belief that the cells will switch from using glucose to ketones for energy?
    And if this is true, how easy is that source of energy is available in case of an emergency, like for example running to catch a bus?
    If you can provide an in depth analysis, that would be so appreciated.
    I really hope you cover this topic.
    Thanks in advance
    Cheers

  • @nadahanna8325
    @nadahanna8325 8 лет назад +1

    Thanks very clear now

  • @steelmonki
    @steelmonki 8 лет назад

    excellent work

  • @squiffedallday
    @squiffedallday 4 года назад

    Currently 6 days out in my keto diet and I found myself here in concerns of ketoacidosis. I was doing OMAD (one meal a day) or a 23 hour fast on top of following a strict keto diet. By day 3 my ketones were off the chart. Doc pulled me in for a urine test and apparently I was at 80. Doctor didn’t seem too concerned because I’m not diabetic and my blood sugar is fine.
    Should I be concerned about potentially damaging my body with the high level of ketones? I’m curious why my ketones spiked so high? I’m tracking all macros and calories and everything is in line with keto.

  • @hafsaaqeely9654
    @hafsaaqeely9654 3 года назад

    I love your channel you are the best thank you so much

  • @amrindersingh007
    @amrindersingh007 11 лет назад

    awesome, Hats off to you sir..