Diabetic ketoacidosis (DKA) is a significant consequence of type 1 diabetes and, to a lesser extent, type 2 diabetes. DKA happens when your blood sugar levels are excessively high and acidic molecules known as ketones build up to dangerous levels in your body.
Ketoacidosis is not the same as ketosis, which is a healthy state. Ketosis can develop as a result of a low carbohydrate diet, known as a ketogenic diet, or as a result of fasting.
DKA occurs when your body does not have enough insulin to convert blood sugar into energy. If this occurs, your liver begins to convert fat into energy, releasing ketones into the blood. Ketone levels in the blood are dangerously high.
It is less prevalent in patients with type 2 diabetes since insulin levels do not typically fall so low, although it can occur. Because persons with type 1 diabetes are unable to produce their own insulin, DKA may be the initial sign of the disease.
SYMPTOMS OF DIABETIC KETOACIDIOSIS
Signs and symptoms of diabetic ketoacidosis can appear quickly, sometimes within 24 hours. These signs and symptoms may be the first indicator of diabetes for some people. You may notice:
- Breathing difficulty
- Belly ache
- Breath that smells fruity or sweet
- Muscle pain
- Headache
- A flushed face
- Confusion
- Fatigue
- Vomiting or Nausea
- Dry skin
- Dry mouth
- Peeing frequently
- Constant thirst
If you experience any of the symptoms listed below and your ketones are moderate to high when tested with a home kit, or if you have more than one symptom, Call your doctor or go to the emergency department as soon as possible:
- You're having trouble breathing.
- You're fatigued, confused, or woozy.
- You've been puking for more than two hours.
- You're feeling nauseous or your stomach hurts.
- Your breath has a fruity odor.
CAUSES AND RISK FACTORS OF DIABETIC KETO ACIDOSIS
Sugar is an important source of energy for the cells that comprise your muscles and other tissues. Normally, insulin aids in the entry of sugar into your cells.
Your body cannot adequately utilise sugar for energy if you do not have enough insulin. This causes the release of hormones that break down fat for fuel, resulting in the production of acids known as ketones. Excess ketones accumulate in the blood and "spill over" into the urine.
Diabetic ketoacidosis is typically caused by:
A disease: An infection or other disease might cause your body to create more hormones, such as adrenaline or cortisol. Unfortunately, these hormones work against insulin, occasionally resulting in diabetic ketoacidosis. The most prevalent causes are pneumonia and urinary tract infections.
An issue with insulin therapy: Inadequate insulin therapy, missed insulin treatments, or a malfunctioning insulin pump might result in insufficient insulin in your system, triggering diabetic ketoacidosis.
Other potential causes of diabetic ketoacidosis include:
- Drugs such as corticosteroids and diuretics
- Abuse of alcohol or drugs, notably cocaine
- Pregnancy
- Pancreatitis
- Stroke or heart attack
- Trauma, either physical or emotional
RISK FACTORS
If you have diabetes, you are more likely to develop diabetic ketoacidosis if you:
- Frequently forget to take insulin doses
- Have type 1Diabetes
Diabetic ketoacidosis is a rare type 2 diabetes condition. Diabetic ketoacidosis may be the first indication of diabetes in some people.
DIAGNOSIS OF DIABETIC KETOACIDIOSIS AND TESTS
When your blood sugar level exceeds 250 mg/dL (milligrams per deciliter) or you have any of the following symptoms of high blood sugar, such as dry mouth, extreme thirst, or frequent urination, test your ketones.
A pee test strip can be used to assess your sugar levels. Ketones are also measured by some glucose meters. Reduce your blood sugar and check your ketones again in 30 minutes.
Your doctor can examine you, inquire about your symptoms, and go over your medical history. They can also request the following tests to detect DKA:
- Electrocardiogram
- Infection detection tests
- Chest x-ray
- Blood pressure
- Arterial blood gas analysis
- Urinalysis
- Blood tests, such as a metabolic panel and electrolytes
WHAT IS THE TREATMENT FOR DIABETIC KETOACIDOSIS?
DKA is often treated with a combination of treatments to restore blood sugar and insulin levels.
If you are diagnosed with DKA but have not yet been diagnosed with diabetes, your doctor will develop a diabetic treatment plan to prevent ketoacidosis from returning.
DKA risk might be increased by infection. If your DKA is caused by an infection or disease, your doctor will treat that as well, most likely with medication.
Replacement of fluids
In the hospital, your doctor will most likely administer intravenous (IV) fluids to assist your body rehydrate. You normally lose a lot of fluids during a DKA incident, which might reduce the amount of blood flowing through your body.
Fluid replacement aids in the restoration of normal blood flow. It also aids in the treatment of dehydration, which can lead to even higher blood sugar levels.
Replacement of electrolytes
When your insulin levels are abnormally low, your electrolytes may also be abnormally low.
Electrolytes are electrically charged minerals that aid in the efficient functioning of your body's organs, including the heart and nerves. Electrolyte replenishment is also often performed using an IV.
Insulin therapy
Insulin will most likely be given to you by IV until your blood sugar level falls below 200 to 250 mg/dL. The emergency care team will also evaluate the results of many other blood tests to determine when insulin therapy is no longer required.
When your blood sugar and other test results are within normal limits, your doctor will work with you to help you avoid DKA in the future.
HOW TO PREVENT DIABETIC KETOACIDOSIS
You can do a lot to avoid diabetic ketoacidosis and other diabetes complications.
- Make a commitment to managing your diabetes: Make good food and physical activity a regular habit. Take diabetes medicines or insulin as prescribed.
- Keep an eye on your blood sugar levels: You should check and record your blood sugar level at least three to four times per day, and more frequently if you're sick or agitated. Only careful monitoring will ensure that your blood sugar level remains within your target range.
- Examine your ketone levels: When you're sick or stressed, use an over-the-counter urine ketones test kit to check your pee for excess ketones. If your ketone level is moderate or high, contact your doctor or seek emergency care straight away. If your ketones are low, you may need to take extra insulin.
- As needed, adjust your insulin dosage: Consult your doctor or a diabetes educator about how to change your insulin dosage based on factors such as your blood sugar level, what you eat, how active you are, and whether you are sick. If your blood sugar level begins to climb, stick to your diabetes treatment plan to go back to your target range.
- Be ready to act fast: If your blood sugar is high and you have extra ketones in your urine, you may have diabetic ketoacidosis. Seek emergency medical attention.
Diabetes consequences are frightening. However, don't allow fear prevent you from taking care of yourself. Maintain a strict adherence to your diabetes treatment regimen. When you require assistance, contact your diabetes treatment team.
CONCLUSION
DKA is a dangerous condition that can be avoided. Maintain a healthy lifestyle by adhering to your diabetes treatment plan.
Inform your doctor if anything isn't functioning or if you're having problems. They can help you change your treatment plan or come up with ways to better manage your diabetes.