Diabetic Ketoacidosis


What is diabetic ketoacidosis? This is a diabetic complication that is very serious and occurs when the body produces too much blood acids known as ketones.


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This disorder develops when the amount of insulin in the body is too low. Insulin plays a main part in helping glucose or sugar – main basis of energy for tissues and muscles – enter the cells. If there is not enough insulin, the body starts to break down fat for fuel. This process creates acids that are toxic in the blood system known as ketones and will lead ultimately to diabetic ketoacidosis if not treated.


If you are a diabetic or you are in danger of diabetes, know the signs of diabetic ketoacidosis as well as when to pursue medical treatment.


Symptoms of Diabetic Ketoacidosis


The symptoms and signs of diabetic ketoacidosis normally develop quickly – often within twenty-four hours. The symptoms include:


• Frequent urination

• Excessive thirst

• Abdominal pain

• Nausea

• Vomiting

• No appetite

• Fatigue or weakness

• Shortness of breath

• Breath that smells fruity

• Confusion


More signs of this condition – can be identified thru home blood as well as urine test kits – and they include:


• High level of blood sugar

• High level of ketones in urine


Symptoms and signs of diabetic ketoacidosis can mimic flu, so it is complicated to identify whether you have some viral infection or a problem that is more serious. If you are stressed or feel sick or you have an injury or recent illness, check blood sugar levels often. An individual can use an over the counter urine test kit to check for ketones


An individual should contact their doctor directly if:


• They are vomiting or unable to accept fluids or food

• Blood sugar level is over their target range

• Blood sugar does not react to any home treatment

• Ketones level in urine is moderate to high


Seek emergency care if:


• Blood sugar/glucose level is steadily higher than 300 mg/dL or 16.7 mmol/L

• Excess ketones are in the urine and your doctor can’t be reached for advice

• Multiple symptoms and signs of diabetic ketoacidosis are occurring


Remember that diabetic ketoacidosis left untreated can be fatal.


Causes of Diabetic Ketoacidosis


The main basis of cell energy in the human body is sugar and it fuels the muscles as well as other tissues. Sugar enters the cells with the aid of insulin. When an individual does not have sufficient insulin in the body, then the body will not be able to use sugar for fuel and this stimulates the discharge of hormones that break down fat as an alternative fuel source. This method produces acids known as ketones that are toxic. Excess ketones collect in the blood as well as ultimately spill over into the urine.


Diabetic ketoacidosis is normally triggered by:


• Any illness – infections or other illnesses can cause the body to generate certain hormones, for example adrenaline. Regrettably, these hormones act against insulin – often producing an incident of diabetic ketoacidosis. Urinary tract infections as well as pneumonia are common offenders.


• Problematic insulin treatment – missing insulin doses or insufficient insulin management can leave an individual with insulin that is not sufficient in the system, thus triggering an episode of diabetic ketoacidosis.

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Other probable triggers can include:


• Stress

• Emotional or physical trauma

• Very high fever

• Heart attack

• Surgery

• Stroke

• Drug or alcohol abuse


The threat of this condition is highest when the individual:


• Has Type 1 diabetes

• Is younger than age 19


Nevertheless, diabetic ketoacidosis can happen in other circumstances – whether the individual has gestational diabetes, Type 1 diabetes, or Type 2 diabetes. And in some cases, diabetic ketoacidosis is the very first time a person knows they have diabetes.


This condition is managed with electrolytes – such as potassium, sodium as well as chlorine – as well as fluids and insulin. Surprisingly, the more common difficulties of this condition are associated to this lifesaving treatment:


• Hypoglycemia or blood sugar that is low. Insulin lets sugar go into your cells. This causes the level of blood sugar to drop. If this level drops too rapidly, you can develop low blood sugar.


• Hypokalemia or low potassium. The insulin and fluids used to treat this condition can cause the potassium level to drop too low. A very low potassium level may damage the actions that affect the muscles, nerves as well as the heart.


• Brain swelling – cerebral edema. Correcting the blood sugar/glucose level too fast often can cause swelling in the brain. This problem appears to be most common in children, especially those who have newly diagnosed diabetes.


If left untreated the risks become even greater. This condition may lead to the loss of consciousness and eventually can be fatal.


Diabetic Ketoacidosis  Treatment


If an individual is diagnosed as having diabetic ketoacidosis, it will probably be in an emergency room or while being admitted to the hospital. Management is normally an approach that has 3 prongs:


Replacement of fluid – The individual will get fluids – either thru an IV or orally – until they are rehydrated. These fluids are needed to replace the fluid that was lost thru too much urination as well as it will help dilute any excessive sugar in the blood.


Replacement of electrolytes – Electrolytes are the minerals contained in the blood system that transmit an electric charge, for example sodium, chloride as well as potassium. The lack of insulin lowers the lever of these several electrolytes in the blood. Electrolytes will need to be received thru your veins to help keep the muscles, heart as well as nerve cells normally functioning.


Therapy with insulin – Insulin reverses the processes that cause diabetic ketoacidosis. So along with treatment by electrolytes as well as fluid, the individual will need insulin therapy – normally thru a vein. If the blood sugar level falls below 240 mg/dL and the blood is no longer acidic, the individual may be able to stop any intravenous insulin therapy and resume normal insulin treatment.


After the individual’s body chemistry has returned to normal, medical professionals will decide what could have triggered this episode of diabetic ketoacidosis. Under some circumstances, the patient might need additional treatment. For instance, if the individual has diabetes that is undiagnosed, the physicians will help create a diabetes plan for treatment. If the doctor diagnoses an infection with bacteria, they will prescribe antibiotics. If a heart attack seems possible, the doctor might recommend further cardiac evaluation.



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