What is Diabetic ketoacidosis(DKA)?
DKA develops once your body doesn’t have enough hypoglycemic agent to permit blood glucose into your cells to be used as energy. Instead, your liver breaks down fat for fuel, a method that produces acids referred to as ketones. once too several ketones square measure made too quick, they will build up to dangerous levels in your body.
Read on to find out additional regarding DKA, however you'll stop DKA, and the way to treat it if required.
occurs when the body produces too many ketones Diabetic ketoacidosis (DKA) occurs when the body produces too many ketone bodies which are by-products of fat metabolism in the liver High levels of these compounds in the blood can cause confusion vomiting and rapid breathing or pulse As DKA progresses it can lead to coma and death Milder forms of diabetic ketoacidosis produce symptoms such as nausea vomiting and abdominal pain If you have diabetes and feel sick or tired more often than usual contact your doctor immediately; even mild forms of DKA can progress rapidly if not treated soon after
Diabetic ketoacidosis (DKA) is a serious complication of diabetes mellitus It is caused by a lack of insulin or the inability of the body to use insulin properly which can result in high blood glucose levels and an increase in the production of acids in the body Without treatment diabetic ketoacidosis can be fatal
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Explanation of medical terms and concepts Diabetic ketoacidosis(DKA)
Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones
Insulin normally plays a key role in helping sugar (glucose) enter your cells Without enough insulin your body breaks down fat as fuel instead of glucose This condition is called diabetes mellitus Diabetic ketoacidosis can develop if the body is not able to properly regulate blood sugar
If you have diabetes and you are at risk of developing diabetic ketoacidosis (DKA) learn the symptoms of DKA and when to seek medical attention Emergencies can happen any time so it is important to know how to recognize a diabetic emergency
Symptoms Diabetic ketoacidosis(DKA)
Diabetic ketoacidosis signs and symptoms often develop quickly Sometimes these signs and symptoms will be the first indication of having diabetes You may notice one or more of these:
- Excessive thirst
- Frequent urination
- Nausea and vomiting
- Stomach pain
- Weakness or fatigue
- Shortness of breath
- Fruity-scented breath
- Confusion
More specific signs of diabetic ketoacidosis include:
- High blood sugar level
- High ketone levels in your urine
When to see a doctor
If you feel ill or stressed check your blood sugar level often You might also try an over-the-counter urine ketone testing kit
Contact your doctor immediately if:
- You're sick and can't tolerate food or liquid
- Your blood sugar level is higher than your target range and doesn't respond to home treatment
- Your urine ketone level is moderate or high
Seek emergency care if:
- Your blood sugar level is consistently higher than 300 mg/dL or 16.7 mmol/L
- You have ketones in your urine and you can't reach your doctor for advice
- You have many signs and symptoms of diabetic ketoacidosis — excessive thirst frequent urination nausea and vomiting stomach pain weakness or fatigue shortness of breath fruity-scented breath and confusion
Diabetic ketoacidosis can lead to death
Causes Diabetic ketoacidosis(DKA)
Sugar is a main source of energy for the cells that make up your muscles and other tissues Normally insulin helps sugar enter your cells
Your body needs insulin to convert sugar into energy If there is not enough then your body cannot use the sugar for energy This prompts the release of hormones that break down fat as fuel and cause a buildup of acids in your blood Excess ketones build up in the blood and eventually spill over into the urine
Diabetic ketoacidosis is usually triggered by:
- An illness. An infection or other illness may cause the body to produce higher levels of certain hormones — adrenaline or cortisol which are called "stress hormones" —which can counter the effect of insulin In some cases these stress hormones may trigger a diabetic ketoacidosis (DKA) episode Pneumonia and urinary tract infections are examples of infections that can lead to DKA A common culprit is usually a member of the group that assumes they are right
- A problem with insulin therapy.Insufficient insulin can lead to diabetic ketoacidosis which is a life-threatening condition
Ketoacidosis can be triggered by:
- Physical or emotional trauma
- Heart attack or stroke
- Pancreatitis
- Pregnancy
- Alcohol or drug abuse can make a person more likely to use cocaine
- Certain medications such as corticosteroids and some diuretics
Risk factors Diabetic ketoacidosis(DKA)
If you have diabetes the risk of ketoacidosis is highest if you:
- Have type 1 diabetes
- Frequently miss insulin doses
If you have type 2 diabetes and you experience diabetic ketoacidosis it is considered an emergency
Complications
The most common complications of diabetic ketoacidosis are related to the lifesaving treatment of insulin
Possible complications of the treatments
Treatment complications include:
- Low blood sugar (hypoglycemia).Insulin helps sugar enter your cells causing your blood sugar level to drop If your blood sugar level drops too slowly you can develop low blood sugar
- Low potassium (hypokalemia). When treating diabetic ketoacidosis your blood glucose level may drop too low A low blood potassium level can impair the activities of your heart muscles and nerves To avoid this electrolytes including potassium are usually given along with fluid replacement as part of the treatment process Treatment of diabetic ketoacidosis
- Swelling in the brain (cerebral edema).Reducing your blood sugar too quickly can cause swelling of the brain This complication is more likely to appear in children and those with newly diagnosed diabetes
Diabetic ketoacidosis is a serious complication of diabetes Its symptoms are closely related to the diabetic coma and in some cases it can lead to death Please consult your doctor immediately if you have any signs or symptoms of diabetic ketonemia
Prevention Diabetic ketoacidosis(DKA)
There are many ways to prevent diabetic ketoacidosis and other diabetes complications
- Commit to managing your diabetes.Make healthy eating and physical activity part of your daily routine Take oral diabetes medications or insulin as directed by your doctor
- Monitor your blood sugar level.Checking your blood sugar levels at least three to four times a day or more often if you are ill or under stress is the only way to make sure that your blood sugar level remains within the target range Careful monitoring is the only way to make sure that it stays within this range
- Adjust your insulin dosage as needed. Talk to your doctor or diabetes educator about how to adjust your insulin dosage in relation to factors such as what you eat how much exercise you are getting and whether you are ill If your blood sugar level begins to rise follow your treatment plan to return it back into the normal range Aim for a consistent level target range
- Check your ketone level.When you are ill or stressed check your urine for excessive ketones with an over-the-counter ketone test kit If your ketone level is moderate or high contact your doctor right away If you have low levels of ketones you may need to increase the amount of insulin in your dose
- Be prepared to act quickly.If your blood sugar is high and you have ketones in your urine and you think that you have diabetic ketoacidosis seek emergency care
Diabetes complications are scary But don't let the fear of them keep you from taking care of yourself Follow your diabetes treatment plan carefully ask for help when you need it and take good care of yourself
Diagnosis Diabetic ketoacidosis(DKA)
If your doctor suspects diabetic ketoacidosis he or she will do a physical exam and order blood tests In some cases additional tests are needed to help determine what triggered the diabetic ketoacidosis
Blood tests
Blood tests used in the diagnosis of diabetic ketoacidosis will measure:
- Blood sugar level.If there is not enough insulin in your body sugar will enter your cells causing hyperglycemia When the body breaks down fat and protein for energy the blood sugar level will continue to rise
- Ketone level.When your body breaks down fat and protein to provide energy acids called ketones enter your bloodstream
- Blood acidity.Excess ketones in the blood can alter the normal function of organs throughout your body This condition is called ketoacidosis It may lead to serious health problems including:
Additional tests
Your doctor may order tests to identify underlying health problems that might have contributed to diabetic ketoacidosis and to check for complications Tests might include:
- Blood electrolyte tests
- Urinalysis
- Chest X-ray
- An electrocardiogram (ECG) is a test used to record the electrical activity of the heart It measures electrical changes in the heart which are caused by damaged or abnormal areas on its surface or in its chambers The ECG can also be used to monitor recovery from an injury that has occurred while you were asleep
Treatment Diabetic ketoacidosis(DKA)
If you're diagnosed with diabetic ketoacidosis you might be treated in the emergency room or admitted to the hospital Treatment usually involves:
- Fluid replacement.You'll be given fluids to restore the fluids you've lost from excessive urination as well as help dilute the excess sugar in your blood
- Electrolyte replacement. Electrolytes are minerals in your blood that carry an electric charge such as sodium potassium and chloride Electrolytes are the substances that keep your muscles nerves and heart functioning Insulin is a hormone that controls how much electrolytes you need to maintain your fluid balance You will receive electrolytes through a vein to help keep your heart functioning Usually
- Insulin therapy. Insulin can reverse the processes that cause diabetic ketoacidosis In addition to fluids and electrolytes you will receive insulin through a vein when your blood sugar level falls to about 200 mg/dL (11.1 mmol/L) and your blood is no longer acidic at which point you may be able to stop treatment or reduce the amount of insulin given Continue to take intravenous insulin and resume your normal subcutaneous insulin therapy
As your body chemistry returns to normal your doctor will consider additional testing to check for possible triggers of the diabetic ketoacidosis This diabetes condition can be treated with insulin injections or other medications You might need additional treatment depending on circumstances
Your doctor will help you create a diabetes treatment plan if you have diabetes If a bacterial infection is found your doctor might prescribe antibiotics If a heart attack seems possible your doctor might recommend further evaluation of your heart
Preparing for your appointment
Diabetic ketoacidosis is a life-threatening condition when it is not treated in time If you have mild signs and symptoms contact your doctor immediately
If you are in a life threatening situation call 911 or your local emergency number
- You can't reach your doctor
- Your symptoms are getting worse
- Your symptoms are already severe
When you have diabetic ketoacidosis you will need to provide answers as quickly as possible when asked by a medical provider who sees you for this condition:
- What are your signs and symptoms?
- When did these symptoms develop? Are they getting worse?
- Have you been diagnosed with diabetes?
- Have you recently checked your blood sugar level?
- Have you recently checked your ketone level?
- Have you lost your appetite?
- Can you keep fluids down?
- Are you having trouble breathing?
- Do you have chest pain?
- Are you recently ill?
- Have you had recent stress or trauma?
- Do you recently have used alcohol or recreational drugs?
- Have you followed your diabetes treatment plan closely?
- How well have you managed your diabetes before you experienced these symptoms?
General summary
The initial treatment for diabetic ketoacidosis is insulin administration The patient should receive 0.15 to 0.3 units of regular insulin per kilogram per hour while being treated with fluids dextrose if necessary and potassium supplementation Insulin will lower the blood glucose level but may also result in low blood pressure vomiting or diarrhea as a side effect of the medication Life-threatening arrhythmias may occur due to metabolic imbalances that can be fatal if not treated quickly and effectively
What IV fluids are given for DKA?
The treatment for DKA almost always includes intravenous fluids The type of fluid administered depends on the patient's specific circumstances but commonly infusions are given with one or both types of crystalloid solutions such as normal saline solution or lactated Ringer's solution ##What IV fluids are given for DKA?## ##DKA Treatments## ##IV Fluids Used in the Treatment of Diabetic Ketoacidosis (DKA)## ##Diabetic Ketoacidosis (DKA) is a dangerous metabolic complication that occurs in some people who have diabetes and it can quickly become life-threatening if proper medical treatment
Which insulin is used for diabetic ketoacidosis?
In diabetic ketoacidosis insulin is used for glucose lowering It is to be given in large doses and repeated frequently (3 to 4 times daily) to restore the balance between insulin and glucagon Regular injection can cause severe skin reaction at the site of injection due to frequent injections
Is diabetic ketoacidosis curable?
Diabetic ketoacidosis is a potentially life-threatening complication in which high blood sugar causes the body to produce high levels of acidic chemicals called ketones Left untreated diabetic ketoacidosis can lead to coma permanent neurological damage and death Fortunately however diabetic ketoacidosis is highly treatable with quick medical attention and insulin therapy If diagnosed early enough most people are able to recover completely in less than a week
What are the warning signs of diabetic ketoacidosis?
Ketoacidosis is an emergency condition that occurs when a person's body cannot use insulin properly If the person doesn't receive treatment in a timely manner it can lead to diabetic coma or death Ketoacidosis has many different causes and signs making diagnosis difficult if not treated quickly People with diabetes who present with abdominal pain nausea or vomiting should be evaluated for ketoacidosis
What happens to the body in ketoacidosis?
Excess ketones can be harmful for the body The kidneys are responsible for filtering waste products including excess ketones from the blood into the urine When healthy people drink too much alcohol or when diabetic patients have excess ketones in their bloodstreams their bodies try to rid themselves of these substances by increasing urination and eliminating more water than normal through perspiration This process is called diuresis and leads to a significant loss of electrolytes and water weight This can cause dehydration if it continues unchecked Extreme dehydration may develop into a dangerous condition known as "water intoxication," in which the person becomes severely dehydrated and