PP KULIAH DM B
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Transcript of PP KULIAH DM B
![Page 1: PP KULIAH DM B](https://reader036.fdocument.pub/reader036/viewer/2022082320/55cf9160550346f57b8d07cd/html5/thumbnails/1.jpg)
Marwanta, SpPD M.KesBagian Ilmu Penyakit Dalam
FK UNS/ RSUD DR MOEWARDI
Kuliah
DIABETES MELITUS( B )
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Koma Diabetikum
Kesadaran Koma
Hipoglikemi
Hiperglikemi
Ketoasidosis
Honk
Laktoasidosis
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Koma Hipoglikemi
Insulin
Koma
Diet OHO
lapar Berdebar
Lemah Pusing
Gemetar Gelisah
Keringat dingin Kesadaran
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Hipoglikemi Murni ( True Hypoglycemia )
Reaksi Hipoglikemi ( Hypoglycemic Reaction )
Hipoglikemi Reaktif ( Reactive Hypoglycemia )
Koma Hipoglikemi ( Hypoglycemic Coma )
< 60 mg%
Cepat
3-5 jam pp
< 30 mg%
Terapi : Ekstra diet Minum bergula Glukosa 40% I.V Glukosa 10% infus
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Koma Ketoasidosis
Insulin
Glukagon
• Hiperglikemi • Ketosis• Asidosis
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Poliuri, Polidipsi
Nausea, Vomitus
Kulit & Mukosa kering
Nafas kuszmaul
Dehidrasi syok
Lemah, Depresi, Kejang
Kesadaran koma
Diagnosis laborat Hiperglikemi berat Glukosuri berat Ketonuri berat pH darah PO O2 Tekanan osmose plasma
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Terapi• Klinik praktis
Cairan NaCl fisiologik• Rumus fluid deficit
Insulin
Menurunkan kadar glukosa darah
Koreksi asidosis
Diet adekuat
Antibiotika
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Koma Hiperosmoler Non Ketotik
Fisik = Ketoasidosis
Tanpa Kuszmaul
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Diagnosis Laborat
Hiperglikemi (> berat dari ketoasidosis)
Tidak ketosis
Tekanan osmose plasma (> tinggi dari
ketoasidosis)
Terapi= Ketoasidosis
Cairan NaCl Hipotoni
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Fisik = ketoasidosis
+ predisposisi
• Gangguan faal
• Syok
• Phenphormin
Hati
Ginjal
Koma Laktoasidosis
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Diagnosis Laborat Hiperglikemi (tidak berat) Bikarbonat pH darah Chlorida Gejala2 faktor2 presipitasi
TERAPI= Ketoasidosis
Koreksi asidosis
Menurunkan kadar laktat
Menekan produksi
• Perbaiki perfusi jaringan
• Atasi penyebab syok
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