Diabetic Ketoacidosis Case Study

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Hernandez, M., Mollo, A., Marsal, J. R., Esquerda, A., Capel, I., Puig-Domingo, M., &
Mauricio, D. (2015). Insulin secretion in patients with latent autoimmune diabetes (LADA): half way between type 1 and type 2 diabetes: action LADA 9. BMC Endocrine Disorders, 15(1), 1-13. doi:10.1186/1472-6823-15-1. The authors included 95 total participates diagnosed with either LADA (n=32), T1DM (n=33), and T2DM (n-30) between the ages of 30-70 to study the levels of C-peptide and insulin secretion levels after a meal. Results of the study show that participates that were diagnosed with LADA had a C-peptide level that average 140.8nmol. This value is between T1DM (41.3 nmol) and T2DM (275.5 nmol). The C-peptide levels were then studied for patients
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Based on using this case report, the authors question the traditional three clinical criteria used to diagnosis LADA: onset at or later then the age of 30, at least one of the four antibodies found in T1DM, and lack of need for insulin for at least 6 months after diagnosis. In the presenting case study an adult patient was seen in an acute care facility with gastroenteritis symptoms. The patient was found to be in diabetic ketoacidosis based on presentation and supported by laboratory blood work. The patient reports increased thirst and urinary frequency for a month without clinical evaluation. Patient was tested for Glutamic acid decarboxylase autoantibodies which results as being positive. The patient was started on subcutaneous insulin at diagnosis and given diabetes education. After three months of diabetic treatment with insulin and biweekly diabetic education to adjust her insulin, the patient’s hemoglobin A1C was resulted as 7.7 …show more content…
LADA is considered a mixture of T1DM and T2DM; thus, the main goals of treatment are similar to the treatment of both types of diabetes. Goals include, “eliminating symptoms of hyperglycemia, reducing life-term complications, and helping the patient to achieve normal lifestyle”. Sulfonylureas should not be used in LADA patients and may makes them progress to insulin dependency more rapidly than other oral medications by depleting beta cells within the pancreases. Oral diabetic agents, such as Metformin and thiazolidinediones, do not cause beta cell depletion or exhaustion and are greatly beneficial to a LADA patient. LADA patient do not have insulin dependency when they are first diagnosed; however, they will evidently progress to insulin dependency if beta cell function is exhausted and function is not restored/conserved. Early insulin use may help conserve beta cell function by stopping them from over working due to

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