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One comment

  1. Elana Megerian

    This would have been a high quality resource if you could have at least said “type 1 diabetes” once. DKA is a classic presentation upon diagnosis of type 1 and it is extremely uncommon in type 2s (and presumably the majority of patients with diabetes that you will see as an EMS are type 2s, so it helps to know what risks exist more for each patient population). As EMTs its essential that you learn and teach the difference so that when you see children who present with what could be and often unfortunately is mistaken for the flu or a severe stomach bug, you can look at DKA as a possibility, Also, I understand what you mean when you say that DKA is not acute, and certainly compared to a hypoglycemic emergency it isn’t acute, but for established type 1s it can still happen surprisingly fast. If you’re looking at a type 1 patient, a kinked cannula in the insulin pump that interferes with delivery can actually cause DKA within a night. This is because patients with type 1 do not have any of their own insulin, so even several hours without exogenous insulin for patients who are only on rapid acting (which is the case with pumps) can have severe consequences. So please please teach and learn the difference between type 1 and type 2. It is not usually enough information to know someone has diabetes.

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