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Diabetic Ketoacidosis

What is Diabetic Ketoacidosis?

Patient Comments
  • Diabetic ketoacidosis (DKA) results from dehydration during a state of relative insulin deficiency, associated with high blood levels of sugar level and organic acids called ketones.
  • Diabetic ketoacidosis is associated with significant disturbances of the body's chemistry, which resolve with proper therapy.
  • Diabetic ketoacidosis usually occurs in people with type 1 (juvenile) diabetes mellitus (T1DM), but diabetic ketoacidosis can develop in any person with diabetes.
  • Since type 1 diabetes typically starts before age 25 years, diabetic ketoacidosis is most common in this age group, but it may occur at any age. Males and females are equally affected.

Diabetic Ketoacidosis Causes

Diabetic ketoacidosis occurs when a person with diabetes becomes dehydrated. As the body produces a stress response, hormones (unopposed by insulin due to the insulin deficiency) begin to break down muscle, fat, and liver cells into glucose (sugar) and fatty acids for use as fuel. These hormones include glucagon, growth hormone, and adrenaline. These fatty acids are converted to ketones by a process called oxidation. The body consumes its own muscle, fat, and liver cells for fuel.

In diabetic ketoacidosis, the body shifts from its normal fed metabolism (using carbohydrates for fuel) to a fasting state (using fat for fuel). The resulting increase in blood sugar occurs, because insulin is unavailable to transport sugar into cells for future use. As blood sugar levels rise, the kidneys cannot retain the extra sugar, which is dumped into the urine, thereby increasing urination and causing dehydration. Commonly, about 10% of total body fluids are lost as the patient slips into diabetic ketoacidosis. Significant loss of potassium and other salts in the excessive urination is also common.

The most common events that cause a person with diabetes to develop diabetic ketoacidosis are:

  • infection such as diarrhea, vomiting, and/or high fever,
  • missed or inadequate insulin, and
  • newly diagnosed or previously unknown diabetes.

Various other causes may include a heart attack, stroke, trauma, stress, alcohol abuse, drug abuse, and surgery. A low percentage of cases have no identifiable cause.

Medically Reviewed by a Doctor on 4/5/2016

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Diabetic Ketoacidosis: After Your Visit

Diabetic ketoacidosis (DKA) is a dangerous illness that occurs when the body lacks insulin and cannot get the sugar it needs for energy, and so it breaks down fat instead. This process makes fatty acids called ketones. The ketones build up in the blood and change the chemical balance in your body. If not treated, this condition can lead to a coma or even death.

DKA can occur if you have little or no insulin in your body and your blood sugar level gets too high. This can happen when you do not take enough insulin, when you have an infection or another illness (such as the flu), or when you are severely dehydrated. DKA occurs mostly in people with type 1 diabetes, but people with type 2 diabetes also can get it. DKA can only be treated with insulin and fluids, which often are given in a vein (IV).

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

SOURCE: HealthWise


Read What Your Physician is Reading on Medscape

Diabetic Ketoacidosis »

Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication of diabetes.

Read More on Medscape Reference »


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