Albumin and DKA

Specialties MICU

Published

Hi all! I'm a student losing my dang mind trying to figure out why a patient of mine (who was in DKA) would have low total protein and serum albumin levels. Can anyone steer me in the right direction with the pathophysiology here? Thanks!

Very simply, because of the inability to transfer glucose into the cell, one of the energy production defaults is protein catabolism which consumes albumin.

Hypoalbuminemia, though, is pretty low on the list of treatment priorities of true DKA. It will normalize once normal glucose metabolism is restored.

Oh wow! Thanks for the help, I can't believe I didn't piece that together.

Very simply, because of the inability to transfer glucose into the cell, one of the energy production defaults is protein catabolism which consumes albumin.

Hypoalbuminemia, though, is pretty low on the list of treatment priorities of true DKA. It will normalize once normal glucose metabolism is restored.

This is a great answer and probably what your school wants. Note though that if the patient is older and/or chronically ill that it is not uncommon for many people to have chronically low protein/albumin levels even if not acutely ill. I always scratch my head when they check these levels on a 70 year old who has had low levels for the last 20 years or so and we haven't treated it yet...what are we going to do with/about it now?

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