Diabetic Ketoacidosis (DKA) Explained Clearly - Diabetes Complications

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.
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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.

[@Tombzy]

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.

[@peybak]

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.)

[@wearethe27]

*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*

[@AYang-gt7dd]

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!!

[@HatchetMouth]

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.

[@diabeeto394]

The way he explains things is perfect. I like the way he pauses after a key word or an explanation of something. It allows the listener to absorb the information rather than a teacher who blurts out the information so fast it becomes white noise. Well done 👍

[@fiddlefigtree3363]

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]

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.

[@zainabchalgani77]

Nice

[@AkSonya1010]

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.

[@pricklypear1111]

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]

Sim Simma Good to hear- thank you for the feedback

[@julieannantis2525]

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

[@dnuts559]

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

[@Medcram]

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

[@Bullzmilk123]

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

[@mattwarry1894]

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

[@Wilsonbuildsthings]

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

[@je6874]

Wilson Lei you’ll do well!

[@jim2980]

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]

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]

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

[@1beckedorf]

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]

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.

[@sjba11er]

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!

[@lisatowe778]

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]

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

[@hollymilam9257]

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

[@emilygreen2436]

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

[@amandakimsey9013]

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

[@Medcram]

Great to hear, thanks!

[@laughingkrikit]

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]

really clear and concise explanation! great review for PICU

[@arion45]

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!

[@9q9v5w]

absolutley fabulous lecture it made analysing acid base peorlems easy

[@andilekheswa2192]

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

[@Medcram]

Andile Kheswa thank you for the feedback

[@billd8346]

Terrific short lecture. Thanks.

[@jillyburt]

Thank you for great, simple explanations.

[@ianvincent845]

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.

[@foomphy]

Nursing student here-this was very helpful-thanks!

[@SilverGray33]

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

[@tomtong9859]

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

[@eugenias471]

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

[@doctortsiurak]

Lection is very interesting and easy for understanding!

[@miriamadorno1939]

thank you for that wonderful explanation on DKA

[@tonychurch6829]

Great video, very clearly explained. Thanks!

[@sublingualsidekick]

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]

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

[@knowledgeenrichment5740]

Your explanation is really good 💜

[@doctorshelp9944]

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

[@Medcram]

DR.JAGAT CHAUDHARY Thank you for the feedback

[@odayalhafdh]

Nice lecture, very illustrative!!

[@gribbles123]

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

[@anklbreakr88]

thank you for the excellent and concise explanation!

[@rumit9946]

Excellent. Thanks for putting this together.

[@benpaul5330]

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

[@kebirbenkaccem726]

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

[@user-uv5dv1hp7c]

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

[@Medcram]

Thank you for watching!

[@damienspillane7053]

Legend. So amazingly well done.

[@dianaayonn]

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

[@Medcram]

+Diana Ayon Good to hear- thanks

[@rdseheult]

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

[@rkiff]

this is a fantastic explanation, thank you

[@tnagan]

Thank you! I was wondering the same thing.

[@KenDBerryMD]

Great video!

[@shavedmax]

Excellent, concise, relevant.

[@MehMah83]

Thanks so much for doing these videos!

[@grbgeslnger24]

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

[@nellyhoffman6194]

Great lecture :) thanks a lot MED CRAM

[@anklbreakr88]

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

[@maksoy69]

eXELLENT EXPRESION. CONGRATULATIONS

[@84nonis]

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

[@jeangeraldgilles2984]

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.

[@MedicEne]

Fantastic lecture

[@AyezaKhan20]

Mind blowing video.Thanks

[@doyceh]

Very helpful in my studies. Thanks

[@leo-rv5xl]

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

[@432Esh]

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

[@rajeshmithun9455]

Nice & concise explanation

[@ExplorerDrlife]

Thanks alot it's very clear n good presentation ❤️

[@sarahscratch8485]

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

[@Medcram]

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

[@TheDAT573]

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.

[@bruinfnp1527]

Thank you so much! Very helpful :)

[@geojor]

thanks for this...

[@emmanuelobadoni3925]

Excellent 👍

[@macwinwinnyday9374]

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

[@dharmrajmaurya605]

great lecture

[@budskirlee]

Thank you for a simple and understandable explanation of DKA

[@Medcram]

budskirlee thanks for the comment

[@luisrank11]

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

[@Medcram]

luisrank11 Thanks for the feedback

[@juansarmiento2022]

Great Lecture

[@eguirald]

Great video.

[@madarasilva424]

Great lecture !

[@prakashchavan4026]

Thank you very much Sir🙏

[@Medcram]

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

[@shellyfrombundy]

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

[@laurenroach974]

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

[@steelmonki]

excellent work

[@hafsaaqeely9654]

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

[@Arianna_justme]

Great explanation..Thank You :)

[@debanjanbhattacharjee1098]

very helpful lecture

[@zindagibakwas9046]

Superb sir

[@lizzymontgomery2337]

Very helpful. It would be great if you could cover the pathophysiology of diabetes mellitus , type 1 & 2. Cheers

[@CantHaveTheMango]

Thanks, John Tesh!

[@johnbunch7185]

Great video!!!!!

[@amrindersingh007]

awesome, Hats off to you sir..

[@daviduresti3783]

Excellent!!! All I can say is = EXCELLENT!!!

[@Medcram]

David Uresti Thanks for the feedback

[@dirkhuman760]

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?

[@janaal-dhubaiee7147]

Thank you so much!

[@iylaoulabi8780]

you... are amazing

[@jnleav]

Very helpful!