PowerPoint presentation on DKA with focus on management for postgraduate internal medicine students use a light colored theme for the design
Reading File
Reading File
Reading File
Finding Sources
Finding Sources
Reading File
Reading File
Reading File
Reading File
Reading File
Reading File
Reading File
Running Command
mkdir -p /tmp/workspace/dka-presentation && ls /tmp/workspace/
Writing File
~/dka-presentation/build_dka.py
from pptx import Presentation
from pptx.util import Inches, Pt, Emu
from pptx.dml.color import RGBColor
from pptx.enum.text import PP_ALIGN, MSO_ANCHOR
from pptx.util import Inches, Pt
from io import BytesIO
# ─── COLOUR PALETTE (light theme) ───────────────────────────────────────────
C_BG = RGBColor(0xF4, 0xF7, 0xFB) # very pale blue-grey background
C_HEADER_BG = RGBColor(0x1A, 0x57, 0x9E) # deep steel-blue header band
C_ACCENT = RGBColor(0x2E, 0x86, 0xC1) # mid-blue accent
C_ACCENT2 = RGBColor(0xE8, 0xF4, 0xFD) # pale blue fill for boxes
C_TEXT_DARK = RGBColor(0x1A, 0x25, 0x3A) # near-black text
C_TEXT_WHITE= RGBColor(0xFF, 0xFF, 0xFF) # white
C_DIVIDER = RGBColor(0x2E, 0x86, 0xC1) # blue divider line
C_BOX_ORANGE= RGBColor(0xFF, 0xA5, 0x00) # amber accent for warnings
C_BOX_RED = RGBColor(0xE7, 0x4C, 0x3C) # red for danger/severe
C_BOX_GREEN = RGBColor(0x27, 0xAE, 0x60) # green for resolution criteria
C_LIGHT_GREY= RGBColor(0xEC, 0xF0, 0xF1) # light grey for table alt rows
C_TABLE_HEAD= RGBColor(0x1A, 0x57, 0x9E) # table header = header blue
prs = Presentation()
prs.slide_width = Inches(13.333)
prs.slide_height = Inches(7.5)
blank = prs.slide_layouts[6]
# ─── HELPERS ────────────────────────────────────────────────────────────────
def add_rect(slide, left, top, width, height, fill_color=None, line_color=None, line_width_pt=0):
from pptx.util import Pt as _Pt
shape = slide.shapes.add_shape(
1, # MSO_SHAPE_TYPE.RECTANGLE
Inches(left), Inches(top), Inches(width), Inches(height)
)
fill = shape.fill
if fill_color:
fill.solid()
fill.fore_color.rgb = fill_color
else:
fill.background()
line = shape.line
if line_color:
line.color.rgb = line_color
line.width = Pt(line_width_pt)
else:
line.fill.background()
return shape
def add_text(slide, text, left, top, width, height,
font_name="Calibri", font_size=14, bold=False, italic=False,
color=C_TEXT_DARK, align=PP_ALIGN.LEFT, v_anchor=MSO_ANCHOR.TOP,
word_wrap=True, margin_l=0.06, margin_t=0.04):
tb = slide.shapes.add_textbox(Inches(left), Inches(top), Inches(width), Inches(height))
tf = tb.text_frame
tf.word_wrap = word_wrap
tf.vertical_anchor = v_anchor
tf.margin_left = Inches(margin_l)
tf.margin_right = Inches(0.04)
tf.margin_top = Inches(margin_t)
tf.margin_bottom= Inches(0.02)
p = tf.paragraphs[0]
p.alignment = align
r = p.add_run()
r.text = text
r.font.name = font_name
r.font.size = Pt(font_size)
r.font.bold = bold
r.font.italic= italic
r.font.color.rgb = color
return tb
def add_bullet_text(slide, items, left, top, width, height,
font_name="Calibri", font_size=13, color=C_TEXT_DARK,
bold_first=False, line_spacing_pt=None):
"""items: list of (indent_level, text) or plain strings."""
tb = slide.shapes.add_textbox(Inches(left), Inches(top), Inches(width), Inches(height))
tf = tb.text_frame
tf.word_wrap = True
tf.margin_left = Inches(0.08)
tf.margin_right = Inches(0.04)
tf.margin_top = Inches(0.04)
tf.margin_bottom= Inches(0.02)
from pptx.util import Pt as _Pt
from pptx.oxml.ns import qn
from lxml import etree
first = True
for item in items:
if isinstance(item, str):
lvl, text = 0, item
else:
lvl, text = item
if first:
p = tf.paragraphs[0]
first = False
else:
p = tf.add_paragraph()
p.level = lvl
if line_spacing_pt:
p.line_spacing = _Pt(line_spacing_pt)
# bullet glyph
pPr = p._pPr if p._pPr is not None else p._p.get_or_add_pPr()
buChar = etree.SubElement(pPr, qn('a:buChar'))
buChar.set('char', '•' if lvl == 0 else '–')
r = p.add_run()
r.text = text
r.font.name = font_name
r.font.size = _Pt(font_size - lvl * 1)
r.font.bold = bold_first and (text == items[0] if isinstance(items[0], str) else False)
r.font.color.rgb = color
return tb
def slide_background(slide, color=C_BG):
bg = slide.background
fill = bg.fill
fill.solid()
fill.fore_color.rgb = color
def add_header_band(slide, title, subtitle=None):
"""Blue header band at top."""
add_rect(slide, 0, 0, 13.333, 1.1, fill_color=C_HEADER_BG)
# top accent stripe
add_rect(slide, 0, 0, 13.333, 0.07, fill_color=C_ACCENT)
add_text(slide, title, 0.35, 0.05, 12.5, 0.65,
font_size=28, bold=True, color=C_TEXT_WHITE,
align=PP_ALIGN.LEFT, v_anchor=MSO_ANCHOR.MIDDLE)
if subtitle:
add_text(slide, subtitle, 0.35, 0.65, 12.5, 0.4,
font_size=14, italic=True, color=RGBColor(0xBE, 0xD9, 0xF5),
align=PP_ALIGN.LEFT)
def add_section_label(slide, text, left, top, width=3.5, color=C_ACCENT):
add_rect(slide, left, top, width, 0.32, fill_color=color)
add_text(slide, text, left+0.08, top, width-0.1, 0.32,
font_size=11, bold=True, color=C_TEXT_WHITE,
align=PP_ALIGN.LEFT, v_anchor=MSO_ANCHOR.MIDDLE, margin_t=0.01)
def add_info_box(slide, title, items, left, top, width, height,
title_color=C_ACCENT, box_color=C_ACCENT2, border_color=C_ACCENT,
font_size=12):
add_rect(slide, left, top, width, height,
fill_color=box_color, line_color=border_color, line_width_pt=1.2)
add_rect(slide, left, top, width, 0.3, fill_color=title_color)
add_text(slide, title, left+0.1, top, width-0.15, 0.3,
font_size=11, bold=True, color=C_TEXT_WHITE,
v_anchor=MSO_ANCHOR.MIDDLE, margin_t=0.01)
add_bullet_text(slide, items, left+0.08, top+0.33, width-0.2, height-0.38,
font_size=font_size, color=C_TEXT_DARK)
def add_page_number(slide, n, total):
add_text(slide, f"{n} / {total}", 12.5, 7.2, 0.8, 0.25,
font_size=9, color=RGBColor(0x9B, 0xA0, 0xAA), align=PP_ALIGN.RIGHT)
# ─── SLIDE BUILDER ──────────────────────────────────────────────────────────
TOTAL = 16 # will update
# ── SLIDE 1 Title ────────────────────────────────────────────────────────
def slide_title(prs):
slide = prs.slides.add_slide(blank)
slide_background(slide)
# big blue panel left
add_rect(slide, 0, 0, 6.0, 7.5, fill_color=C_HEADER_BG)
add_rect(slide, 0, 0, 6.0, 0.12, fill_color=C_BOX_ORANGE)
add_rect(slide, 0, 7.38, 6.0, 0.12, fill_color=C_BOX_ORANGE)
add_text(slide, "DIABETIC\nKETOACIDOSIS", 0.3, 1.2, 5.4, 3.0,
font_size=44, bold=True, color=C_TEXT_WHITE,
align=PP_ALIGN.LEFT, v_anchor=MSO_ANCHOR.MIDDLE)
add_text(slide, "Pathophysiology, Diagnosis & Management",
0.3, 4.0, 5.4, 0.8,
font_size=18, italic=True, color=RGBColor(0xBE, 0xD9, 0xF5),
align=PP_ALIGN.LEFT)
add_text(slide, "Postgraduate Internal Medicine | August 2026",
0.3, 4.9, 5.4, 0.5,
font_size=12, color=RGBColor(0x90, 0xB8, 0xD8))
# right side
add_text(slide, "Key Focus Areas", 6.5, 1.2, 6.5, 0.4,
font_size=18, bold=True, color=C_ACCENT)
topics = [
"Pathophysiology of DKA",
"Diagnostic criteria & severity classification",
"Precipitating factors",
"Fluid resuscitation protocols",
"Insulin therapy",
"Electrolyte management (K⁺, phosphate, bicarbonate)",
"Monitoring & endpoints of treatment",
"Complications & prevention",
"Special scenarios (SGLT-2i, pregnancy, euglycaemic DKA)",
]
add_bullet_text(slide, topics, 6.5, 1.7, 6.5, 5.5,
font_size=13.5, color=C_TEXT_DARK)
add_page_number(slide, 1, TOTAL)
# ── SLIDE 2 Overview / Epidemiology ─────────────────────────────────────
def slide_overview(prs):
slide = prs.slides.add_slide(blank)
slide_background(slide)
add_header_band(slide, "Overview & Epidemiology")
# 3 stat boxes
boxes = [
("~30%", "of T1DM patients experience\nDKA at some point"),
("~0.4%", "mortality in experienced\ncentres (up to 5–10% globally)"),
("3–5 L", "average fluid deficit\nat presentation"),
]
for i, (stat, desc) in enumerate(boxes):
lft = 0.4 + i * 4.3
add_rect(slide, lft, 1.25, 3.8, 1.5, fill_color=C_ACCENT2, line_color=C_ACCENT, line_width_pt=1.5)
add_text(slide, stat, lft, 1.35, 3.8, 0.7,
font_size=34, bold=True, color=C_ACCENT, align=PP_ALIGN.CENTER)
add_text(slide, desc, lft, 2.0, 3.8, 0.65,
font_size=12, color=C_TEXT_DARK, align=PP_ALIGN.CENTER)
# definition box
add_rect(slide, 0.4, 3.0, 12.5, 0.95, fill_color=RGBColor(0xFF,0xF3,0xCD), line_color=C_BOX_ORANGE, line_width_pt=1.5)
add_text(slide, "Definition: DKA is a life-threatening metabolic emergency characterised by the triad of hyperglycaemia (glucose >11 mmol/L), "
"ketonaemia (β-hydroxybutyrate >3.0 mmol/L), and metabolic acidosis (pH <7.3, HCO₃ <15 mmol/L) resulting from absolute or relative insulin deficiency.",
0.5, 3.05, 12.2, 0.85, font_size=12.5, color=C_TEXT_DARK)
# key facts
add_section_label(slide, "EPIDEMIOLOGY", 0.4, 4.1)
pts = [
"More common in T1DM but occurs in T2DM (~30% of episodes in some series)",
"Incidence of DKA is rising worldwide; reasons unclear",
"Leading cause of death in young patients with T1DM",
"DKA at T1DM diagnosis is common in children & adolescents",
"SGLT-2 inhibitor-associated euglycaemic DKA increasingly recognised",
]
add_bullet_text(slide, pts, 0.4, 4.5, 12.5, 2.7, font_size=12.5)
add_page_number(slide, 2, TOTAL)
# ── SLIDE 3 Pathophysiology ──────────────────────────────────────────────
def slide_patho(prs):
slide = prs.slides.add_slide(blank)
slide_background(slide)
add_header_band(slide, "Pathophysiology")
# central box
add_rect(slide, 4.8, 1.3, 3.7, 0.65, fill_color=C_BOX_RED)
add_text(slide, "↓ INSULIN + ↑ COUNTER-REGULATORY HORMONES\n(glucagon, cortisol, catecholamines, GH)",
4.82, 1.32, 3.66, 0.62,
font_size=10.5, bold=True, color=C_TEXT_WHITE, align=PP_ALIGN.CENTER)
# Three consequence columns
cols = [
("HYPERGLYCAEMIA", C_ACCENT, [
"↑ Glycogenolysis",
"↑ Gluconeogenesis",
"↓ Peripheral glucose uptake",
"Osmotic diuresis → dehydration",
"Electrolyte loss (Na⁺, K⁺, PO₄³⁻, Mg²⁺)",
]),
("KETOGENESIS / ACIDOSIS", RGBColor(0xD3, 0x54, 0x00), [
"↑ Lipolysis → ↑ Free fatty acids",
"Hepatic β-oxidation → ketone bodies",
"Acetoacetate & β-hydroxybutyrate",
"Anion-gap metabolic acidosis",
"Kussmaul breathing (compensation)",
]),
("DEHYDRATION / ELECTROLYTES", RGBColor(0x14, 0x75, 0x5E), [
"Total body K⁺ depleted (shift out with acidosis)",
"Total body phosphate depleted",
"Serum K⁺ may appear normal/high",
"Na⁺ often low (dilutional)",
"Severe fluid deficit: 3–5 L",
]),
]
for i, (title, col, pts) in enumerate(cols):
lft = 0.35 + i * 4.32
add_rect(slide, lft, 2.1, 4.0, 0.38, fill_color=col)
add_text(slide, title, lft+0.08, 2.1, 3.84, 0.38,
font_size=11, bold=True, color=C_TEXT_WHITE,
v_anchor=MSO_ANCHOR.MIDDLE, margin_t=0.02)
add_rect(slide, lft, 2.48, 4.0, 2.8, fill_color=C_ACCENT2, line_color=col, line_width_pt=1)
add_bullet_text(slide, pts, lft+0.1, 2.52, 3.8, 2.7, font_size=12.5, color=C_TEXT_DARK)
# bottom note
add_rect(slide, 0.35, 5.42, 12.6, 0.45, fill_color=RGBColor(0xFD,0xED,0xEC), line_color=C_BOX_RED, line_width_pt=1)
add_text(slide, "Key insight: Serum K⁺ at presentation may be NORMAL or HIGH despite severe total body K⁺ depletion — insulin therapy will drive K⁺ intracellularly and can precipitate life-threatening hypokalaemia.",
0.45, 5.44, 12.4, 0.42, font_size=11.5, bold=False, color=C_BOX_RED)
add_page_number(slide, 3, TOTAL)
# ── SLIDE 4 Precipitating Factors ────────────────────────────────────────
def slide_precip(prs):
slide = prs.slides.add_slide(blank)
slide_background(slide)
add_header_band(slide, "Precipitating Factors — The '6 I's'")
cats = [
("Infection", C_BOX_RED,
["Pneumonia, UTI, sepsis", "Most common precipitant (~40%)", "Fever may be absent in DKA"]),
("Insulin omission", C_ACCENT,
["Non-compliance with insulin", "Pump failure / infusion set problem", "Deliberate omission (diabulimia)"]),
("Ischaemia / Infarction", RGBColor(0x84, 0x27, 0x93),
["Myocardial infarction", "Cerebrovascular event", "Mesenteric ischaemia"]),
("Intoxication / Drugs", RGBColor(0xD3, 0x54, 0x00),
["Cocaine, alcohol", "Corticosteroids", "Atypical antipsychotics, SGLT-2i"]),
("New-onset T1DM", RGBColor(0x14, 0x75, 0x5E),
["DKA as first presentation", "Esp. in children & young adults", "HbA1c normal/slightly elevated"]),
("Other / Pregnancy", RGBColor(0x6C, 0x35, 0x83),
["Pancreatitis", "Trauma, surgery, stress", "Pregnancy (T1DM & gestational)"]),
]
for i, (title, col, pts) in enumerate(cats):
row, c = divmod(i, 3)
lft = 0.35 + c * 4.32
top = 1.25 + row * 2.85
add_rect(slide, lft, top, 4.0, 0.38, fill_color=col)
add_text(slide, title, lft+0.08, top, 3.84, 0.38,
font_size=12, bold=True, color=C_TEXT_WHITE, v_anchor=MSO_ANCHOR.MIDDLE, margin_t=0.02)
add_rect(slide, lft, top+0.38, 4.0, 2.1, fill_color=C_ACCENT2, line_color=col, line_width_pt=1)
add_bullet_text(slide, pts, lft+0.1, top+0.42, 3.8, 2.0, font_size=12.5)
add_page_number(slide, 4, TOTAL)
# ── SLIDE 5 Clinical Features ───────────────────────────────────────────
def slide_clinical(prs):
slide = prs.slides.add_slide(blank)
slide_background(slide)
add_header_band(slide, "Clinical Features")
# left: symptoms
add_info_box(slide, "SYMPTOMS", [
"Polyuria, polydipsia",
"Nausea, vomiting",
"Abdominal pain (may mimic acute abdomen)",
"Weakness, fatigue",
"Altered consciousness (severe DKA)",
], 0.35, 1.25, 4.0, 3.5)
# mid: signs
add_info_box(slide, "PHYSICAL SIGNS", [
"Tachycardia",
"Hypotension / dehydration",
"Kussmaul respirations (deep, rapid)",
"Fruity / acetone breath",
"Abdominal tenderness",
"Reduced consciousness / coma",
"Signs of precipitating illness",
], 4.7, 1.25, 4.0, 3.5)
# right: investigations
add_info_box(slide, "IMMEDIATE INVESTIGATIONS", [
"Blood glucose (fingerprick + lab)",
"Serum/blood ketones (β-OHB preferred)",
"U&E, creatinine, osmolality",
"ABG / VBG (pH, HCO₃, pCO₂)",
"FBC, CRP, blood cultures",
"ECG (peaked T-waves if hyperkalaemia)",
"CXR, urine dipstick & MSU",
], 9.05, 1.25, 4.0, 3.5)
# bottom anion-gap formula
add_rect(slide, 0.35, 4.9, 12.6, 0.7, fill_color=C_ACCENT2, line_color=C_ACCENT, line_width_pt=1.2)
add_text(slide, "Anion Gap = Na⁺ – (Cl⁻ + HCO₃⁻) Normal: 8–12 mEq/L DKA: typically >16 mEq/L (elevated AG metabolic acidosis)",
0.5, 4.92, 12.3, 0.66, font_size=13, bold=False, color=C_TEXT_DARK, align=PP_ALIGN.CENTER)
# corrected Na formula
add_rect(slide, 0.35, 5.68, 12.6, 0.55, fill_color=RGBColor(0xFF,0xF3,0xCD), line_color=C_BOX_ORANGE, line_width_pt=1)
add_text(slide, "Corrected Na⁺ = Measured Na⁺ + 2.4 × [(Glucose mg/dL – 100) / 100] | Effective Osmolality = 2×Na⁺ + Glucose/18",
0.5, 5.7, 12.3, 0.52, font_size=12, color=C_TEXT_DARK, align=PP_ALIGN.CENTER)
add_page_number(slide, 5, TOTAL)
# ── SLIDE 6 Severity Classification ─────────────────────────────────────
def slide_severity(prs):
slide = prs.slides.add_slide(blank)
slide_background(slide)
add_header_band(slide, "Severity Classification of DKA")
# table
headers = ["Parameter", "MILD", "MODERATE", "SEVERE"]
rows = [
["Blood glucose", ">250 mg/dL (>13.9 mmol/L)", ">250 mg/dL", ">250 mg/dL"],
["Arterial pH", "7.25 – 7.30", "7.00 – 7.24", "< 7.00"],
["Serum HCO₃", "15 – 18 mEq/L", "10 – 14 mEq/L", "< 10 mEq/L"],
["Urine/serum ketones", "Positive", "Positive", "Positive"],
["β-Hydroxybutyrate", "> 3.0 mmol/L", "> 3.0 mmol/L", "> 3.0 mmol/L"],
["Anion gap", "> 10", "> 12", "> 12"],
["Mental status", "Alert", "Alert / drowsy", "Stupor / coma"],
]
col_widths = [2.6, 2.8, 2.8, 2.8]
row_height = 0.52
tbl_left = 0.55
tbl_top = 1.25
header_colors = [C_HEADER_BG, C_ACCENT, RGBColor(0xD3,0x54,0x00), C_BOX_RED]
# header row
for j, (hdr, w, col) in enumerate(zip(headers, col_widths, header_colors)):
left = tbl_left + sum(col_widths[:j])
add_rect(slide, left, tbl_top, w, row_height, fill_color=col)
add_text(slide, hdr, left+0.05, tbl_top, w-0.05, row_height,
font_size=12, bold=True, color=C_TEXT_WHITE,
align=PP_ALIGN.CENTER, v_anchor=MSO_ANCHOR.MIDDLE, margin_t=0.02)
# data rows
for i, row in enumerate(rows):
row_top = tbl_top + (i+1) * row_height
bg = C_LIGHT_GREY if i % 2 == 0 else C_TEXT_WHITE
for j, (cell, w) in enumerate(zip(row, col_widths)):
left = tbl_left + sum(col_widths[:j])
add_rect(slide, left, row_top, w, row_height,
fill_color=bg, line_color=RGBColor(0xCC,0xDD,0xEE), line_width_pt=0.5)
bold = j == 0
add_text(slide, cell, left+0.05, row_top, w-0.05, row_height,
font_size=11.5, bold=bold, color=C_TEXT_DARK,
align=PP_ALIGN.CENTER if j > 0 else PP_ALIGN.LEFT,
v_anchor=MSO_ANCHOR.MIDDLE, margin_t=0.02)
# note
add_rect(slide, 0.55, 5.05, 12.4, 0.55, fill_color=RGBColor(0xFD,0xED,0xEC), line_color=C_BOX_RED, line_width_pt=1)
add_text(slide, "Note: ADA/Endocrine Society criteria. DKA + HHS may coexist (up to one-third of patients). "
"Euglycaemic DKA (SGLT-2i): glucose <250 mg/dL with pH <7.3 and ketonaemia.",
0.65, 5.07, 12.2, 0.52, font_size=11.5, color=C_BOX_RED)
add_page_number(slide, 6, TOTAL)
# ── SLIDE 7 Management Overview ─────────────────────────────────────────
def slide_mgmt_overview(prs):
slide = prs.slides.add_slide(blank)
slide_background(slide)
add_header_band(slide, "Management Overview — The 5 Pillars")
pillars = [
("1\nFLUIDS", C_ACCENT,
"IV fluid resuscitation\nRestore circulating volume\nCorrect dehydration over 24–48 h"),
("2\nINSULIN", RGBColor(0x14, 0x75, 0x5E),
"IV regular insulin infusion\n0.1 U/kg/h (after K⁺ ≥3.5 mmol/L)\nStop ketogenesis"),
("3\nPOTASSIUM", RGBColor(0xD3, 0x54, 0x00),
"Replace K⁺ before starting insulin\nTarget 4.0–5.0 mmol/L\nContinuous monitoring"),
("4\nMONITOR", RGBColor(0x84, 0x27, 0x93),
"Hourly glucose\n1–2 hourly ketones & VBG\nFluid balance, ECG"),
("5\nPRECIPITANT", RGBColor(0x6C, 0x35, 0x83),
"Identify & treat trigger\nAntibiotics if infection\nHold SGLT-2i; review insulin regimen"),
]
for i, (label, col, desc) in enumerate(pillars):
lft = 0.35 + i * 2.58
# circle-like square
add_rect(slide, lft, 1.3, 2.35, 1.05, fill_color=col)
add_text(slide, label, lft, 1.3, 2.35, 1.05,
font_size=18, bold=True, color=C_TEXT_WHITE,
align=PP_ALIGN.CENTER, v_anchor=MSO_ANCHOR.MIDDLE)
add_rect(slide, lft, 2.35, 2.35, 3.5, fill_color=C_ACCENT2, line_color=col, line_width_pt=1.2)
add_text(slide, desc, lft+0.1, 2.5, 2.2, 3.2,
font_size=12.5, color=C_TEXT_DARK, v_anchor=MSO_ANCHOR.TOP)
add_rect(slide, 0.35, 6.0, 12.6, 0.5, fill_color=RGBColor(0xFF,0xF3,0xCD), line_color=C_BOX_ORANGE, line_width_pt=1)
add_text(slide, "GOLDEN RULE: Do NOT start insulin if K⁺ < 3.3 mmol/L. Replete potassium first to avoid fatal arrhythmia.",
0.5, 6.02, 12.3, 0.48, font_size=13, bold=True, color=RGBColor(0x7D,0x3C,0x00), align=PP_ALIGN.CENTER)
add_page_number(slide, 7, TOTAL)
# ── SLIDE 8 Fluid Therapy ───────────────────────────────────────────────
def slide_fluids(prs):
slide = prs.slides.add_slide(blank)
slide_background(slide)
add_header_band(slide, "Fluid Resuscitation")
add_info_box(slide, "INITIAL RESUSCITATION (1st hour)", [
"If haemodynamic shock: NS 0.9% or Ringer's Lactate bolus — as fast as possible",
"If no shock: NS 0.9% 1 L over 1st hour",
"Bolus 20 mL/kg in children",
"Ringer's Lactate associated with faster DKA resolution & less hyperchloraemia",
], 0.35, 1.25, 6.0, 2.6, font_size=12.5)
add_info_box(slide, "SUBSEQUENT FLUIDS (hours 2–24)", [
"After 1st hour: switch to 0.45% NaCl at 150–500 mL/h depending on fluid status",
"Correct total deficit (~3–5 L) over 24–48 h",
"Switch to 5% dextrose + 0.45% NaCl when glucose reaches 200–250 mg/dL",
"Continue insulin infusion even after glucose falls (to clear ketones)",
], 6.7, 1.25, 6.3, 2.6, font_size=12.5)
add_info_box(slide, "SPECIAL CONSIDERATIONS", [
"Elderly / cardiac disease: cautious fluid replacement; monitor for pulmonary oedema",
"Children: avoid rapid large fluid boluses — risk of cerebral oedema",
"Aim urine output 0.5–1 mL/kg/h",
"Avoid large volumes of 0.9% NaCl — hyperchloraemic acidosis may worsen apparent acidosis",
], 0.35, 4.05, 6.0, 2.8, font_size=12.5, title_color=RGBColor(0x14, 0x75, 0x5E), border_color=RGBColor(0x14, 0x75, 0x5E))
add_info_box(slide, "ENDPOINTS OF FLUID THERAPY", [
"Haemodynamic stability (HR, BP normalised)",
"Urine output >0.5 mL/kg/h",
"Clinical signs of dehydration resolving",
"Transition to oral intake when tolerating",
], 6.7, 4.05, 6.3, 2.8, font_size=12.5, title_color=RGBColor(0xD3, 0x54, 0x00), border_color=RGBColor(0xD3, 0x54, 0x00))
add_page_number(slide, 8, TOTAL)
# ── SLIDE 9 Insulin Therapy ─────────────────────────────────────────────
def slide_insulin(prs):
slide = prs.slides.add_slide(blank)
slide_background(slide)
add_header_band(slide, "Insulin Therapy")
add_info_box(slide, "STARTING INSULIN", [
"Check K⁺ BEFORE starting insulin",
"If K⁺ < 3.3 mmol/L: DO NOT start insulin — replete K⁺ first",
"If K⁺ ≥ 3.3 mmol/L: start insulin infusion",
"IV regular insulin bolus: 0.1 U/kg then infusion 0.1 U/kg/h",
"Alternative: no bolus + infusion 0.14 U/kg/h (ADA 2023)",
], 0.35, 1.25, 6.0, 3.2, font_size=12.5)
add_info_box(slide, "ADJUSTING THE INFUSION", [
"Target glucose fall: 50–75 mg/dL (2.8–4.2 mmol/L) per hour",
"If glucose falls <50 mg/dL/h in first hour: double insulin rate",
"When glucose reaches 200–250 mg/dL: add 5% dextrose to IV fluids",
"Reduce insulin infusion to 0.02–0.05 U/kg/h once glucose <200 mg/dL",
"Do NOT stop insulin until ketones cleared (pH >7.3, HCO₃ >18, AG normal)",
], 6.7, 1.25, 6.3, 3.2, font_size=12.5)
add_info_box(slide, "TRANSITION TO SUBCUTANEOUS INSULIN", [
"Switch to SC insulin when: pH >7.3, HCO₃ >18 mmol/L, AG normalised, patient tolerating orally",
"Overlap SC long-acting insulin by 2–4 h before stopping IV infusion",
"Restart usual SC insulin regimen (or initiate for new T1DM)",
"Risk of rebound ketosis if IV insulin stopped prematurely",
], 0.35, 4.6, 12.6, 2.7, font_size=12.5,
title_color=RGBColor(0x14, 0x75, 0x5E), border_color=RGBColor(0x14, 0x75, 0x5E))
add_page_number(slide, 9, TOTAL)
# ── SLIDE 10 Potassium & Electrolytes ───────────────────────────────────
def slide_electrolytes(prs):
slide = prs.slides.add_slide(blank)
slide_background(slide)
add_header_band(slide, "Electrolyte Management")
# Potassium table
add_rect(slide, 0.35, 1.25, 5.8, 0.35, fill_color=C_HEADER_BG)
add_text(slide, "POTASSIUM REPLACEMENT PROTOCOL (ADA)", 0.45, 1.25, 5.6, 0.35,
font_size=11, bold=True, color=C_TEXT_WHITE, v_anchor=MSO_ANCHOR.MIDDLE, margin_t=0.02)
k_rows = [
("K⁺ < 3.3 mmol/L", "HOLD INSULIN — Replace K⁺ 40 mEq/h IV. Recheck hourly until K⁺ ≥ 3.3", C_BOX_RED),
("K⁺ 3.3 – 5.5 mmol/L", "Start insulin + add 20–40 mEq KCl per litre of IV fluid. Target K⁺ 4–5 mmol/L", C_BOX_ORANGE),
("K⁺ > 5.5 mmol/L", "Start insulin but NO potassium supplementation. Recheck K⁺ every 2 hours", RGBColor(0x14, 0x75, 0x5E)),
]
for i, (label, action, col) in enumerate(k_rows):
top = 1.6 + i * 0.65
add_rect(slide, 0.35, top, 2.1, 0.6, fill_color=col)
add_text(slide, label, 0.4, top, 2.0, 0.6, font_size=11, bold=True, color=C_TEXT_WHITE,
v_anchor=MSO_ANCHOR.MIDDLE, margin_t=0.02)
add_rect(slide, 2.45, top, 3.7, 0.6, fill_color=C_ACCENT2, line_color=col, line_width_pt=1)
add_text(slide, action, 2.5, top, 3.6, 0.6, font_size=10.5, color=C_TEXT_DARK,
v_anchor=MSO_ANCHOR.MIDDLE, margin_t=0.02)
# Phosphate
add_info_box(slide, "PHOSPHATE", [
"Severe hypophosphataemia (<1.0 mg/dL): replace with potassium phosphate",
"Routine replacement NOT recommended (no outcome benefit demonstrated)",
"May worsen hypocalcaemia if given aggressively",
], 6.5, 1.25, 6.5, 2.0, font_size=12, title_color=RGBColor(0xD3, 0x54, 0x00), border_color=RGBColor(0xD3, 0x54, 0x00))
# Bicarbonate
add_info_box(slide, "BICARBONATE — GENERALLY NOT RECOMMENDED", [
"No RCT evidence of benefit; may paradoxically worsen CNS acidosis",
"Consider ONLY if: pH < 6.9 or haemodynamic instability despite resuscitation",
"If given: 100 mEq NaHCO₃ over 2 h with 20 mEq KCl; recheck pH after",
], 6.5, 3.4, 6.5, 2.0, font_size=12, title_color=C_BOX_RED, border_color=C_BOX_RED)
# Magnesium / other
add_info_box(slide, "MAGNESIUM & SODIUM", [
"Mg²⁺ depletion common — replace if symptomatic or <0.6 mmol/L",
"Sodium: monitor corrected Na⁺; hypernatraemia may indicate excessive free water loss",
"Chloride: avoid hyperchloraemia with normal saline; consider balanced crystalloid",
], 0.35, 3.65, 5.8, 2.35, font_size=12)
add_page_number(slide, 10, TOTAL)
# ── SLIDE 11 Monitoring & Targets ───────────────────────────────────────
def slide_monitoring(prs):
slide = prs.slides.add_slide(blank)
slide_background(slide)
add_header_band(slide, "Monitoring & Treatment Targets")
# monitoring frequency table
add_rect(slide, 0.35, 1.25, 7.5, 0.38, fill_color=C_HEADER_BG)
add_text(slide, "MONITORING FREQUENCY", 0.45, 1.25, 7.3, 0.38,
font_size=12, bold=True, color=C_TEXT_WHITE, v_anchor=MSO_ANCHOR.MIDDLE, margin_t=0.02)
mon_rows = [
("Blood glucose", "Every 1 hour"),
("Blood/urine ketones (β-OHB preferred)", "Every 1–2 hours"),
("VBG (pH, HCO₃, K⁺)", "Every 2 hours initially"),
("Serum electrolytes (K⁺, Na⁺, Cl⁻)", "Every 2–4 hours"),
("Fluid balance (input/output)", "Hourly"),
("ECG", "On admission; repeat if K⁺ abnormal"),
("Vital signs (BP, HR, RR, SpO₂, GCS)", "Every 30–60 minutes"),
]
for i, (test, freq) in enumerate(mon_rows):
top = 1.63 + i * 0.5
bg = C_LIGHT_GREY if i % 2 == 0 else C_TEXT_WHITE
add_rect(slide, 0.35, top, 4.8, 0.5, fill_color=bg, line_color=RGBColor(0xCC,0xDD,0xEE), line_width_pt=0.5)
add_rect(slide, 5.15, top, 2.7, 0.5, fill_color=bg, line_color=RGBColor(0xCC,0xDD,0xEE), line_width_pt=0.5)
add_text(slide, test, 0.45, top, 4.65, 0.5, font_size=11.5, color=C_TEXT_DARK, v_anchor=MSO_ANCHOR.MIDDLE, margin_t=0.02)
add_text(slide, freq, 5.2, top, 2.6, 0.5, font_size=11.5, color=C_TEXT_DARK, v_anchor=MSO_ANCHOR.MIDDLE, margin_t=0.02)
# resolution criteria
add_info_box(slide, "RESOLUTION CRITERIA (all 3 must be met)", [
"Blood glucose < 200 mg/dL (11.1 mmol/L)",
"Serum HCO₃ ≥ 18 mEq/L",
"Venous pH > 7.3",
"Anion gap normalised (≤12 mEq/L)",
"Serum/blood ketones clearing (β-OHB < 0.5 mmol/L)",
], 8.3, 1.25, 4.7, 3.6, title_color=C_BOX_GREEN, border_color=C_BOX_GREEN, font_size=12.5)
add_info_box(slide, "IMPORTANT PITFALLS", [
"Pseudonormoglycaemia in SGLT-2i DKA",
"Bicarbonate lag behind pH during resolution",
"Premature insulin cessation → rebound ketosis",
"Overlooking concurrent illness (MI, sepsis)",
], 8.3, 5.0, 4.7, 2.0, title_color=C_BOX_RED, border_color=C_BOX_RED, font_size=12.5)
add_page_number(slide, 11, TOTAL)
# ── SLIDE 12 Complications ──────────────────────────────────────────────
def slide_complications(prs):
slide = prs.slides.add_slide(blank)
slide_background(slide)
add_header_band(slide, "Complications of DKA & Its Treatment")
comp = [
("Cerebral Oedema", C_BOX_RED, [
"Most feared complication — especially in children",
"Risk: rapid fluid shifts, excess hypotonic fluid, insulin-induced glucose fall",
"Features: headache, altered consciousness, papilloedema, bradycardia",
"Treatment: mannitol 0.5–1 g/kg IV or hypertonic saline; reduce fluids",
]),
("Hypokalaemia", RGBColor(0xD3, 0x54, 0x00), [
"Common after insulin + fluid therapy",
"Can cause fatal ventricular arrhythmias",
"Prevention: K⁺ replacement protocol (see slide 10)",
"ECG monitoring essential",
]),
("Hypoglycaemia", C_ACCENT, [
"From over-aggressive insulin without dextrose",
"Prevent by adding dextrose when glucose <200 mg/dL",
"Do not stop insulin — reduce rate; continue dextrose",
]),
("Aspiration Pneumonia", RGBColor(0x6C, 0x35, 0x83), [
"In obtunded patients with vomiting",
"Insert NGT if altered consciousness",
"Nurse at 30–45° head elevation",
]),
("Acute Kidney Injury", RGBColor(0x14, 0x75, 0x5E), [
"Pre-renal from severe dehydration",
"Usually resolves with fluid resuscitation",
"Monitor creatinine, urine output",
]),
("Thrombosis / Rhabdomyolysis", RGBColor(0x84, 0x27, 0x93), [
"DVT/PE risk increased in DKA",
"Consider prophylactic LMWH in admitted patients",
"Rhabdomyolysis: check CK; aggressive fluids",
]),
]
for i, (title, col, pts) in enumerate(comp):
row, c = divmod(i, 3)
lft = 0.35 + c * 4.32
top = 1.25 + row * 2.8
add_rect(slide, lft, top, 4.0, 0.38, fill_color=col)
add_text(slide, title, lft+0.08, top, 3.84, 0.38,
font_size=11, bold=True, color=C_TEXT_WHITE, v_anchor=MSO_ANCHOR.MIDDLE, margin_t=0.02)
add_rect(slide, lft, top+0.38, 4.0, 2.1, fill_color=C_ACCENT2, line_color=col, line_width_pt=1)
add_bullet_text(slide, pts, lft+0.1, top+0.42, 3.8, 2.0, font_size=11.5)
add_page_number(slide, 12, TOTAL)
# ── SLIDE 13 Special Scenarios ──────────────────────────────────────────
def slide_special(prs):
slide = prs.slides.add_slide(blank)
slide_background(slide)
add_header_band(slide, "Special Scenarios")
add_info_box(slide, "EUGLYCAEMIC DKA (SGLT-2 INHIBITOR ASSOCIATED)", [
"Blood glucose often 100–200 mg/dL — easily missed!",
"Mechanism: glucosuria masking hyperglycaemia + altered ketone metabolism",
"Manage like standard DKA: fluids, insulin, electrolytes",
"Start dextrose early to maintain glucose while clearing ketones",
"Stop SGLT-2 inhibitor; do NOT restart until DKA fully resolved",
"Avoid perioperative SGLT-2i — withold 3–4 days before elective surgery",
], 0.35, 1.25, 12.6, 2.5, font_size=12.5, title_color=RGBColor(0x14, 0x75, 0x5E), border_color=RGBColor(0x14, 0x75, 0x5E))
add_info_box(slide, "DKA IN PREGNANCY", [
"Can occur at lower glucose levels (~200 mg/dL) — accelerated starvation ketosis",
"Fetal mortality high if untreated — urgent management",
"Larger fluid volumes may be needed; monitor fetal heart rate",
"Insulin requirements change rapidly — involve obstetric & endocrine teams",
], 0.35, 3.9, 6.0, 2.8, font_size=12.5, title_color=RGBColor(0x84, 0x27, 0x93), border_color=RGBColor(0x84, 0x27, 0x93))
add_info_box(slide, "KETOSIS-PRONE (ATYPICAL) DKA (TYPE 1.5 / FLATBUSH)", [
"Obese adults, often Hispanic or African descent",
"Presents as classic DKA with T2DM phenotype",
"After DKA treatment: insulin secretory capacity recovers",
"Many can be managed long-term with OHA; not lifelong insulin dependent",
"HbA1c often markedly elevated at presentation",
], 6.7, 3.9, 6.3, 2.8, font_size=12.5, title_color=RGBColor(0xD3, 0x54, 0x00), border_color=RGBColor(0xD3, 0x54, 0x00))
add_page_number(slide, 13, TOTAL)
# ── SLIDE 14 DKA vs HHS ─────────────────────────────────────────────────
def slide_dka_hhs(prs):
slide = prs.slides.add_slide(blank)
slide_background(slide)
add_header_band(slide, "DKA vs Hyperglycaemic Hyperosmolar State (HHS)")
headers = ["Feature", "DKA", "HHS", "Euglycaemic DKA"]
rows = [
["Typical patient", "T1DM, young", "T2DM, elderly", "T2DM on SGLT-2i"],
["Blood glucose", "11–33 mmol/L", "33–66 mmol/L", "5.5–13.9 mmol/L"],
["Serum ketones", "+++", "+/–", "+++"],
["pH", "< 7.3", "> 7.3", "< 7.3"],
["HCO₃", "< 18 mEq/L", "> 18 mEq/L", "< 18 mEq/L"],
["Osmolality", "> 300 mOsm/kg", "> 320 mOsm/kg", "Normal"],
["Fluid deficit", "3–5 L", "8–10 L", "2–4 L"],
["Onset", "Hours (24h)", "Days–weeks", "Variable"],
["Mortality", "< 1% (expert centre)", "5–20%", "< 1%"],
]
col_widths = [2.5, 2.8, 2.8, 2.8]
row_h = 0.5
tbl_left = 0.55
tbl_top = 1.28
hdr_cols = [C_HEADER_BG, C_ACCENT, RGBColor(0xD3,0x54,0x00), RGBColor(0x14,0x75,0x5E)]
for j, (h, w, col) in enumerate(zip(headers, col_widths, hdr_cols)):
left = tbl_left + sum(col_widths[:j])
add_rect(slide, left, tbl_top, w, row_h, fill_color=col)
add_text(slide, h, left+0.05, tbl_top, w-0.05, row_h,
font_size=12, bold=True, color=C_TEXT_WHITE, align=PP_ALIGN.CENTER,
v_anchor=MSO_ANCHOR.MIDDLE, margin_t=0.02)
for i, row in enumerate(rows):
top = tbl_top + (i+1) * row_h
bg = C_LIGHT_GREY if i % 2 == 0 else C_TEXT_WHITE
for j, (cell, w) in enumerate(zip(row, col_widths)):
left = tbl_left + sum(col_widths[:j])
add_rect(slide, left, top, w, row_h, fill_color=bg,
line_color=RGBColor(0xCC,0xDD,0xEE), line_width_pt=0.5)
add_text(slide, cell, left+0.05, top, w-0.05, row_h,
font_size=11, bold=(j==0), color=C_TEXT_DARK,
align=PP_ALIGN.CENTER if j>0 else PP_ALIGN.LEFT,
v_anchor=MSO_ANCHOR.MIDDLE, margin_t=0.02)
add_rect(slide, 0.55, 5.95, 12.4, 0.55, fill_color=RGBColor(0xFF,0xF3,0xCD), line_color=C_BOX_ORANGE, line_width_pt=1)
add_text(slide, "Up to one-third of patients have overlapping features of BOTH DKA and HHS. Treat the dominant picture and reassess continuously.",
0.65, 5.97, 12.2, 0.52, font_size=12, color=RGBColor(0x7D,0x3C,0x00))
add_page_number(slide, 14, TOTAL)
# ── SLIDE 15 Prevention & Sick-Day Rules ────────────────────────────────
def slide_prevention(prs):
slide = prs.slides.add_slide(blank)
slide_background(slide)
add_header_band(slide, "Prevention & Sick-Day Management")
add_info_box(slide, "SICK-DAY RULES FOR PATIENTS WITH T1DM", [
"NEVER stop insulin during illness even if not eating",
"Monitor blood glucose every 2–4 hours",
"Check blood/urine ketones if glucose >13.9 mmol/L",
"Maintain hydration — small frequent sips; avoid sugary drinks if glucose high",
"Seek urgent medical review if: vomiting, ketones positive, glucose uncontrolled, confusion",
"Carry glucagon & wear medical ID at all times",
], 0.35, 1.25, 6.0, 4.0, font_size=12.5)
add_info_box(slide, "CLINICAL PREVENTION STRATEGIES", [
"Structured diabetes education programmes (DAFNE etc.)",
"Continuous glucose monitoring (CGM) with alarms",
"Insulin pump — consider HCL (hybrid closed loop) systems",
"Optimise HbA1c to reduce chronic complications without hypoglycaemia",
"Review precipitants after each DKA episode",
"Screen and treat infections promptly",
"Address diabulimia / psychological barriers to insulin use",
], 6.7, 1.25, 6.3, 4.0, font_size=12.5)
add_rect(slide, 0.35, 5.5, 12.6, 0.85, fill_color=RGBColor(0xFD,0xED,0xEC), line_color=C_BOX_RED, line_width_pt=1)
add_text(slide, "POST-DKA DISCHARGE: Review insulin regimen. Arrange early diabetes educator review. "
"Psychosocial assessment if recurrent DKA. "
"A single episode of DKA is associated with increased long-term mortality and microvascular risk — "
"reinforce importance of adherence.",
0.5, 5.52, 12.3, 0.82, font_size=12, color=C_TEXT_DARK)
add_page_number(slide, 15, TOTAL)
# ── SLIDE 16 Summary Flowchart ──────────────────────────────────────────
def slide_summary(prs):
slide = prs.slides.add_slide(blank)
slide_background(slide)
add_header_band(slide, "Clinical Management Flowchart — Quick Reference")
steps = [
("STEP 1\n(0 min)", C_BOX_RED,
"RESUSCITATION: Airway, Breathing, Circulation | Large-bore IV access x2 | O₂ if SpO₂ <94%\nBlood glucose, ketones, VBG, U&E, FBC, CRP, blood cultures | Catheter & fluid balance chart"),
("STEP 2\n(0–60 min)", C_ACCENT,
"FLUIDS: NS 0.9% (or Ringer's) 1 L over 1 hour | Assess haemodynamics"),
("STEP 3\n(0–60 min)", RGBColor(0xD3, 0x54, 0x00),
"CHECK K⁺: If K⁺ < 3.3 → replace K⁺, hold insulin | If K⁺ ≥ 3.3 → start insulin infusion 0.1 U/kg/h"),
("STEP 4\n(1–6 h)", RGBColor(0x14, 0x75, 0x5E),
"MAINTAIN: Continue fluids (0.45% NaCl) | Add K⁺ 20–40 mEq/L to fluids | Hourly glucose; 2-hourly VBG\nWhen glucose 200–250: add 5% dextrose | Reduce insulin to 0.02–0.05 U/kg/h"),
("STEP 5\n(6–24 h)", RGBColor(0x6C, 0x35, 0x83),
"TREAT PRECIPITANT: Antibiotics if infection | Stop SGLT-2i | ECG / troponin if suspected ACS"),
("STEP 6\n(Resolution)", C_BOX_GREEN,
"TRANSITION: pH >7.3, HCO₃ >18, AG normal → switch to SC insulin (overlap 2–4 h)\nStart oral intake | Diabetes education before discharge | Follow-up plan"),
]
for i, (label, col, desc) in enumerate(steps):
top = 1.25 + i * 1.0
add_rect(slide, 0.35, top, 1.5, 0.85, fill_color=col)
add_text(slide, label, 0.35, top, 1.5, 0.85, font_size=11, bold=True,
color=C_TEXT_WHITE, align=PP_ALIGN.CENTER, v_anchor=MSO_ANCHOR.MIDDLE)
add_rect(slide, 1.85, top, 11.1, 0.85, fill_color=C_ACCENT2, line_color=col, line_width_pt=1)
add_text(slide, desc, 1.95, top, 10.9, 0.85, font_size=11.5, color=C_TEXT_DARK,
v_anchor=MSO_ANCHOR.MIDDLE, margin_t=0.04)
add_page_number(slide, 16, TOTAL)
# ─── BUILD ALL SLIDES ───────────────────────────────────────────────────────
slide_title(prs)
slide_overview(prs)
slide_patho(prs)
slide_precip(prs)
slide_clinical(prs)
slide_severity(prs)
slide_mgmt_overview(prs)
slide_fluids(prs)
slide_insulin(prs)
slide_electrolytes(prs)
slide_monitoring(prs)
slide_complications(prs)
slide_special(prs)
slide_dka_hhs(prs)
slide_prevention(prs)
slide_summary(prs)
out_path = "/tmp/workspace/dka-presentation/DKA_Management_PG_IM.pptx"
prs.save(out_path)
print(f"Saved: {out_path}")
print(f"Slides: {len(prs.slides)}")
Running Command
cd /tmp/workspace/dka-presentation && python build_dka.py 2>&1
Running Command
ls -lh /tmp/workspace/dka-presentation/DKA_Management_PG_IM.pptx
Your presentation is ready for download:
DKA Management PG IM
Presentation · PPTX
Here is what is included across all 16 slides, built with a pale blue-grey light theme, deep steel-blue headers, and colour-coded info boxes:
| Slide | Title |
|---|---|
| 1 | Title slide with key focus areas |
| 2 | Overview & Epidemiology (stat boxes + definition) |
| 3 | Pathophysiology (3-column: hyperglycaemia / ketogenesis / dehydration) |
| 4 | Precipitating Factors - the "6 I's" |
| 5 | Clinical Features - symptoms, signs & immediate investigations |
| 6 | Severity Classification table (Mild / Moderate / Severe — ADA criteria) |
| 7 | Management Overview - The 5 Pillars |
| 8 | Fluid Resuscitation (initial, subsequent, special considerations) |
| 9 | Insulin Therapy (starting, adjusting, transition to SC) |
| 10 | Electrolyte Management - K⁺ protocol table, phosphate, bicarbonate |
| 11 | Monitoring frequency table & Resolution Criteria |
| 12 | Complications of DKA & Treatment (6-box layout) |
| 13 | Special Scenarios (euglycaemic DKA/SGLT-2i, pregnancy, ketosis-prone) |
| 14 | DKA vs HHS comparison table |
| 15 | Prevention & Sick-Day Rules |
| 16 | Clinical Management Flowchart - step-by-step quick reference |
Content is sourced from Harrison's Principles of Internal Medicine 22E (2025) and Rosen's Emergency Medicine, with ADA electrolyte replacement protocols and current guidance on SGLT-2 inhibitor-associated euglycaemic DKA.
This is a shared conversation. Sign in to Orris to start your own chat.