Diseases & Conditions

 

Diabetic Ketoacidosis

Diseases & Conditions

 

What is diabetic ketoacidosis?

Diabetic ketoacidosis is a life-threatening condition that affects people with diabetes. When the cells of the body cannot get enough glucose (sugar) for energy, the body starts to use fat as an alternative source. This occurs when the body does not have enough insulin to use glucose, the body’s normal source of energy. When the body starts to break down fat, high level of acids called ketones are produced and enter the blood leading to a chemical imbalance called diabetic ketoacidosis.1

 

What causes diabetic ketoacidosis?

Ketoacidosis can be caused by different conditions:1

  • People with type 1 and type 2 diabetes: When the body does not have enough insulin to use the glucose for energy, it breaks down fat and ketone will appear in the blood causing ketoacidosis
  • Having a severe infection: Infection causes a stress response in the body by increasing the amount of certain hormones such as cortisol and adrenaline that will counter the effect of insulin leading to ketoacidosis.
  • Dehydration: A lack of insulin plus dehydration can add up to diabetic ketoacidosis. Most patients with diabetic ketoacidosis have moderate to severe dehydration.

 

What are the risk factors for diabetic ketoacidosis?

The most common risk factors for diabetic ketoacidosis include:2

  • Type 1 diabetes mellitus
  • Concomitant infections
  • Missed or disrupted insulin treatments


 What are the symptoms of diabetic ketoacidosis?

Signs and symptoms of diabetic ketoacidosis include:3

  • Excessive thirst
  • Dry mouth
  • Frequent urination
  • Hyperglycemia
  • High levels of ketones in the urine
  • Weakness
  • Fatigue
  • Nausea
  • Vomiting
  • Abdominal pain
  • Dry skin
  • Shortness of breath
  • Fruity odor on breath
  • Confusion

 

How is diabetic ketoacidosis diagnosed?

Tests to diagnose ketoacidosis include:4

  • Urinalysis: Ketones can be detected with a simple urine test.
  • Blood tests:
    • Blood glucose level: Hyperglycemia is observed in patients with ketoacidosis.
    • Ketones level: Ketones levels such as beta-hydroxybutyrate are measured in the blood.
    • Blood acidity
  • Arterial blood gas: This test is used to evaluate the body’s acid/base balance
  • Basic metabolic panel: This is a group of blood tests that measure electrolytes levels and kidney function
  • Blood pressure measurement

 

 How is diabetic ketoacidosis treated?

Treatment of ketoacidosis includes:5

  • Fluid replacement: Intravenous fluid replacement should start immediately to counteract the effects of dehydration.
  • Electrolyte replacement: The lack of insulin can decrease the levels of electrolyte in the blood. Sodium, Potassium and Chloride replacement therapy is required for treatment of diabetic ketoacidosis.
  • Insulin therapy: Insulin reverses the processes that cause diabetic ketoacidosis.

 

References:

  1. WebMD http://www.webmd.com/diabetes/tc/diabetic-ketoacidosis-dka-topic-overview (Accessed February 1, 2016)
  2. : Practice Essentials, Background, Pathophysiology http://emedicine.medscape.com/article/118361-overview#a5 (Accessed February 1, 2016)
  3. American Diabetes Association http://www.diabetes.org/living-with-diabetes/complications/ketoacidosis-dka.html?referrer=https%3A%2F%2Fwww.google.ae%2F (Accessed February 1, 2016)
  4. S National Library of Medicine https://www.nlm.nih.gov/medlineplus/ency/article/000320.htm (Accessed February 1, 2016)
  5. Treatments and drugs http://www.mayoclinic.org/diseases-conditions/diabetic-ketoacidosis/basics/treatment/con-20026470 (Accessed February 1, 2016)