Albumin and DKA

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Hey there! This is a bit of a crosspost, but I'm a student having trouble understanding a couple lab values going back over some clinical paperwork.

Why would a patient in DKA have low total protein and albumin levels? My texts keep saying that hypoalbuminemia and DKA can occur together, but not exactly why. Can anyone steer me in the right direction on the pathophysiology here?

Thanks!

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Specializes in Thoracic Cardiovasc ICU Med-Surg.

Ok, well think about what is being metabolized during DKA. If you understand the pathophys, you will understand why the wonky lab values. In other words, do your research.

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Specializes in tele, stepdown/PCU, med/surg.

Next time you take care of patients, look at the albumin levels of your patients. I bet more than half will be lower than normal. The sicker they are, often the lower the albumin.

Z

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So I was able to make this connection the other day, actually.

In the absence of insulin, cells can't use glucose and the body starts to break down fat and protein for energy. I knew this, but for one reason or another - I think it's because the focus in DKA is so heavily on the byproducts of fat metabolism - it didn't click that protein catabolism = low serum albumin.

Understanding that critically ill patients in general are hypermetabolic and will likely be losing a lot of their protein is useful too, so thank you.

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Specializes in Thoracic Cardiovasc ICU Med-Surg.

I read this question off to my 17 year old type one diabetic daughter. This was her answer. "Because your body is eating all your protein and fats because it can't use glucose. Duh."

LOL!!

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....but I'm a student having trouble understanding

I read this question off to my 17 year old type one diabetic daughter. This was her answer. "Because your body is eating all your protein and fats because it can't use glucose. Duh."

The OP is a student and came here to get some help in a nonjudgmental way. Your reply sounded snarky.

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Specializes in Cath/EP lab, CCU, Cardiac stepdown.

off the top of my head the body uses protein as the source of energy which produces ketones, ketoacidosis. Which is why you have that fruity breath and rapid shallow breathing. It's the body's attempt to get rid of and to correct the imbalance.

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