•   Defined by triad: Hyperglycemia, Acidosis, Ketosis

Treatment:

• Insulin: Initially 5-10 units/hour
  Maintenance 2-4 units/hour
• Goal: Glucose < 250 dl/L
  Serial finger stick glucose checks

1. Correct volume loss:
        Normal Saline I.V.
2. Anion gap: When corrected means acidosis is corrected.
3. Serial K+. Once volume restored, replace K+ as needed.
4. Check Phosphates
5. Consider Bicarbonate based on ICU protocol.

•  Defined: A diabetic patient with altered mental status and whose labs reveal
       Plasma Osmolarity > 350 mEq/L
       Plasma Glucose >600 dl/L
       No Serum Ketones.
• Treatment:
  1. Volume expansion
  2. Corrected blood pressure/Serial vital signs
  3. KCL replacement
  4. Consider insulin infusion
  5. Look for complications of volume loss
          Myocardial infraction
          Large vessal thromboembolism
  6. Monitor glucose and K+ serially

Defined: Hyponatremia due to excessive volume loss
     Urine osmolarity - High
     Serum osmolarity - Low

• Etiology:Tumors, Tuberculosis, Pneumonia, CNS disease, Drugs: Phenothiazides, morphine.
• Treatment: Fluid restriction

Defined:: Lack of Anti-diuretic hormone causes free water wasting.
• Etiology:Head trauma, pituitary tumor, infection, sarcoidosis.
• Treatment: Vasopressin initially
       DDA VP for chronic treatment.