🩸 Diabetes Mellitus · Type 1 & DKA · Recognition Tool

Schwartz Clinical Handbook — Chapter 26 · Polyuria · Polydipsia · Weight loss · DKA · Insulin regimens · Hypoglycemia

Select classic symptoms (polyuria, polydipsia, weight loss), DKA features (Kussmaul, fruity breath, altered mental status), and risk factors → guide diagnosis, laboratory workup, and emergency management.
⚠️ Red flags: altered mental status, Kussmaul breathing, vomiting, dehydration → DKA emergency (IV fluids, insulin drip).

📋 Step 1 — Clinical & metabolic features
📌 Diagnostic impressions
📖 Schwartz Ch 26

Select polyuria, polydipsia, weight loss, polyphagia, enuresis, DKA signs (Kussmaul, vomiting, AMS), and relevant history → system differentiates type 1 diabetes, stress hyperglycemia, and DKA severity, and recommends labs (BG, A1c, ketones, electrolytes).

✔️ Classic trio: polyuria, polydipsia, weight loss = diabetes until proven otherwise.
✔️ DKA: pH <7.3, bicarbonate <15, ketonemia.
✔️ Initial insulin: 0.1 U/kg IV bolus then 0.1 U/kg/h (DKA).
📘 Schwartz pearls (Chapter 26)
• DKA cerebral edema risk: avoid rapid fluid shifts, sodium overcorrection.
• Insulin pump therapy improves glycemic control.
• Rule of 500 for insulin‑to‑carb ratio (450 for toddlers).
• Sick day management: never omit insulin, check ketones.