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Diabetic Ketoacidosis

Diabetic Ketoacidosis is a serious complication of Diabetes. It can also be referred to as DKA. This condition is much more prevalent with Type 1 Diabetes but it also may occasionally occur in Type 2 Diabetes as well.

Diabetic Ketoacidosis is a serious and potentially life-threatening risk of diabetes and shouldn’t be overlooked in patients with a history of high blood sugar readings. It can be seen in patients when they first start having symptoms of diabetes. Sometimes, the patient is not yet aware of the diagnosis. It can be one of the first signs (a late sign) of new onset diabetes. Often treatment needs to occur with IV fluids, IV insulin, and close monitoring. Hospitalization is often required.

Prior to the discovery of Insulin for the treatment of diabetes, DKA caused a large number of deaths.

When can it be seen?

1.)  It is often seen in a patient who is unaware of their illness of diabetes.
2.)  They often require an emergency visit and present with DKA symptoms
3.)  May also be seen in someone who fails to take their prescribed insulin
4.) Can be seen with certain illnesses in a diabetic individual such as: Infection, Pneumonia, Bronchitis, Recent surgery, or other significant medical complication.

Causes:

–  High blood sugar
–  Acidosis
–  Large amount of ketone bodies
–  Often a minimal amount of insulin is present in the blood stream

Ketone Production:

–  Occurs in low insulin situations
–  Liver believes it is starving
–  The liver will then produce ketone bodies for fuel

Symptoms:

–  Fatigue
–  Increase urination
–  Inability to drink enough water – always thirsty
–  Fruity smell to breathe
–  Confusion
–  Anger
–  Vomiting
–  Muscle pain
–  Acidosis
–  Blood pH drops
–  Muscle wasting
–  Weight loss

Late Stage Symptoms:

–  Unconsciousness
–  Extreme confusion
–  Abdominal pain
–  Vomiting (can occur in early stages as well)
–  Difficulty or irregular breathing (may be very deep)
–  Death

Treatment

1.)  Hydration
2.)  Replacement of electrolytes
3.)  Hospitilazation in many cases
4.)  Ventilation may be necessary
5.)  Intubation may be necessary
6.)  Insulin