abdominal pain in dka

 Q: Abdominal pain in Diabetic keto-acidosis (DKA) is associated with the severity of the metabolic acidosis? (select one)

A) True

B) False

Answer: A

Abdominal pain is an important clinical indicator in severe hyperglycemic states. 

1. It is very unusual in Hyperosmolar Hyperglycemic State (HHS). Its presence indicates probable DKA. 

2. It correlates with the severity of the metabolic acidosis, but not with the severity of hyperglycemia or dehydration. Severe abdominal pain in DKA speaks of very low serum bicarbonate, may be less than 5 mEq/L). If it continues to persist after acidosis is resolved, than underlying pancreatitis need to be ruled out.

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Reference:

Umpierrez G, Freire AX. Abdominal pain in patients with hyperglycemic crises. J Crit Care. 2002;17(1):63-67. doi:10.1053/jcrc.2002.33030