McMaster Textbook of Internal Medicine

McMaster Textbook of Internal Medicine
Interviews
Endocrinology
Can DKA develop in type 2 diabetes?

Can DKA develop in type 2 diabetes?

2024-05-11

René Rodríguez-Gutiérrez

Recorded at the 9th McMaster International Review Course in Internal Medicine (MIRCIM).

René Rodríguez-Gutiérrez, MD, is a professor of medicine at the Autonomous University of Nuevo León in Mexico and associate professor at Mayo Clinic, USA. His research interests include insulin resistance and glycemic control in type 2 diabetes.

Can diabetic ketoacidosis (DKA) develop in a patient with type 2 diabetes?

René Rodríguez-Gutiérrez, MD: That’s a very interesting question because we usually think about DKA in type 1 diabetes, but as evidence has shown, DKA is even more frequent in type 2 diabetes. What happens is that, for sure, there has to be an absolute insulin deficiency for us to have DKA. But what happens in patients with type 2 diabetes is that they have a precipitating cause, which usually increases these contributory hormones such as cortisol and adrenaline, which actually makes the patients insulin deficient. Then the cascade of DKA can come up.

So, definitely yes: [DKA is] many times even more frequent than hyperglycemic hyperosmolar state (HHS) in patients with type 2 diabetes.

See also

Oral pancreatic enzyme supplementation in chronic pancreatitis How to monitor the effectiveness of oral pancreatic enzyme supplementation in patients with chronic pancreatitis? When to increase the dose? Can pancreatic enzymes be overdosed? If yes, what are the signs and symptoms? Does the overdosing pose a risk to the patient? With Dr Marianna Arvanitakis.
Management of severe hyponatremia with SIAD How to manage patients with acute signs and symptoms of syndrome of inappropriate diuresis, including rapidly progressing hyponatremia? With Dr Ally Prebtani.
Long-term use of bisphosphonates in osteoporosis When is the long-term bisphosphonate use justified in the treatment of osteoporosis and when can it be paused? With Dr Alexandra Papaioannou.
Indications for the use of SGLT-2 inhibitors in type 2 diabetes In which clinical settings are there indications to initiate the treatment of type 2 diabetes with SGLT-2 inhibitors? With Dr Leszek Czupryniak.
The role of potassium in DKA treatment Why is it important to monitor serum potassium and supplement potassium in patients treated for diabetic ketoacidosis (DKA)? With Dr René Rodríguez-Gutiérrez.
Diabetic ketoacidosis (DKA) Diabetic ketoacidosis: all that you need to remember about presentation, diagnosis, and management reviewed in less than 10 minutes.

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