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Diabetes: Symptoms, Diagnosis, and Complications01:15

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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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Hypoglycemia and Glucagon01:15

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Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
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Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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Pathophysiology of Diabetes01:20

Pathophysiology of Diabetes

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Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
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Carbohydrate Metabolism01:36

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Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
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Acute Pancreatitis II: Clinical Manifestations and Management01:30

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Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
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Related Experiment Video

Updated: Jun 24, 2025

Glycemic Impact on Knee Osteoarthritis Symptoms on Physical, Radiographic, and Inflammatory Markers among Individuals Aged 50 and Over with Diabetes
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Glycemic Impact on Knee Osteoarthritis Symptoms on Physical, Radiographic, and Inflammatory Markers among Individuals Aged 50 and Over with Diabetes

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Diabetic Ketoalkalosis: A Case Report.

April Brill1, Nirav Chheda1, Daniel Strama2

  • 1Franciscan Health Olympia Fields, Emergency Department, Olympia Fields, Illinois.

Clinical Practice and Cases in Emergency Medicine
|June 13, 2024
PubMed
Summary

Diabetic ketoacidosis (DKA) can present with metabolic alkalosis, a rare finding. Recognizing this atypical presentation is crucial for appropriate emergency department treatment and patient outcomes.

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Area of Science:

  • Emergency Medicine
  • Internal Medicine
  • Endocrinology

Background:

  • Diabetic ketoacidosis (DKA) is a frequent emergency department (ED) diagnosis.
  • Acid-base disturbances in DKA typically present as metabolic acidosis.
  • Atypical presentations necessitate considering alternative diagnoses or coexisting conditions.

Purpose of the Study:

  • To highlight a case of DKA with concurrent metabolic alkalosis.
  • To emphasize the importance of considering DKA even with non-typical acid-base findings.
  • To underscore the potential risks of misdiagnosis in the ED.

Main Methods:

  • Case report of a 52-year-old female with type 2 diabetes mellitus.
  • Diagnostic workup including venous blood gas analysis.
  • Initiation of standard DKA treatment.

Main Results:

  • The patient presented with symptoms consistent with DKA, including abdominal pain, nausea, and vomiting.
  • Diagnostic workup revealed DKA with concurrent metabolic alkalosis.
  • Standard DKA treatment led to improved mentation and resolution of metabolic derangements.

Conclusions:

  • Metabolic alkalosis can coexist with diabetic ketoacidosis.
  • Failure to diagnose DKA due to the presence of alkalosis can lead to adverse patient outcomes.
  • Vigilance for DKA is essential in patients presenting with acid-base disturbances, regardless of typical patterns.