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Resident: DKA: A Story of Access to Insulin
EP30883
Poster Title: Resident: DKA: A Story of Access to Insulin
Submitted on 23 Oct 2019
Author(s): Erik Rodriguez, MD., Vaidehi Ambai, DO., Viktoria Nurpiesov, MD., G.E., Alan Dever, MD, PhD.
Affiliations: Wellstar Kennestone Regional Hospital
Poster Views: 250
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Poster Information
Abstract: Diabetic ketoacidosis (DKA) can reveal itself in a remarkably wide range of presentations; from polydipsia to coma. Intriguingly, the patient’s chief complaint may not always align with the severity of their illness. Family practice physicians serve as an important link in the chain of survival for those in danger but without alarming, acute symptoms. A 27-year-old man presented to clinic with a history of diabetes mellitus type I, which was diagnosed as a teenager. Though not in immediate distress, after a thorough history and physical exam, an Emergency Room evaluation was needed. There, he was found to be in DKA with an extremely elevated HbA1c. This case highlights the importance of maintaining an adequate level of clinical suspicion and taking steps to ensure that no patient is overlooked for lack of obvious signs of distress. Summary: DKA is a life-threatening complication but is also one that we, as providers, can help prevent.  As a family physician it is one of our primary goals to build rapport and trust with our patients. With partnerships with our patients, we highlight the importance of preventionReferences: References:
DKA cases over the last three years: has anything changed? Straitgou T, Vallianou N, et al. Diabetes and Metabolic Syndrome: Clinical Research and Reviews, 2019-03-01, Volume 13, Issue 2, Pages 1639-1641, Diabetes India. 
ANDREW SMITH, MD, and CHELSEA HARRIS, MD, Lawrence Family Medicine Residency Program, Lawrence, Massachusetts. Am Fam Physician. 2018 Aug 1;98(3):154-162.
DYANNE P. WESTERBERG, DO, Cooper Medical School of Rowan University, Camden, New Jersey. Am Fam Physician. 2013 Mar 1;87(5):337-346.
https://makeinsulinaffordable.org/
https://www.jdrf.org/t1d-resources/living-with-t1d/insurance/help-with-your-diabetes-prescription-costs/
https://care.diabetesjournals.org/content/41/6/1299
https://www.t1international.com/insulin-and-supply-survey/
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