What is diabetic ketoacidosis?
Diabetic ketoacidosis (DKA) can be life-threatening. The cause is insufficient insulin and the body’s cells cannot use glucose for energy. When the sugar cannot get into the cells, it stays in the blood. The kidneys filter some of the sugar from the blood and remove it from the body through the urine. Since the cells cannot get sugar for energy, the body will start to break down fat and muscle for energy. At this point, ketones or fatty acids are produced and enter the bloodstream, causing a chemical imbalance (metabolic acidosis), a condition called diabetic ketoacidosis.
What causes diabetic ketoacidosis?
Ketoacidosis can be caused by insufficient insulin, severe infection or other illness, severe dehydration, or a combination of these conditions.
It occurs when patients, most of whom have type 1 diabetes, especially children, but also some with type 2 diabetes, have elevated blood glucose levels and no or little insulin in their bodies.
What are the symptoms of diabetic ketoacidosis?
Blood glucose may be very high before the patient notices symptoms. Symptoms include:
- Flushing, fever, and dry skin.
- Blurred vision.
- Thirst and excessive urination.
- Sleepiness or difficulty getting up. The child may lack interest in daily activities.
- Breathing is fast and deep.
- Breath has a strong fruity taste.
- Loss of appetite, abdominal pain, vomiting.
- Mental disorders.
How is diabetic ketoacidosis diagnosed?
- Laboratory tests, including blood tests and urine tests, are used to confirm the diagnosis of diabetic ketoacidosis.
- Ketone tests for home use.
- Have some test strips handy in case of elevated blood glucose.
How to treat diabetic ketoacidosis?
In severe cases, ketoacidosis must be treated in a hospital, usually in an intensive care unit. Treatment includes intravenous insulin and fluids, and close monitoring of certain chemicals (electrolytes) in the blood. Doctors and nurses will monitor the patient closely to ensure that the patient’s brain does not swell while the infusion is used to treat dehydration. It may take several weeks to bring blood glucose levels back into the target range.
How do I prevent diabetic ketoacidosis?
Diabetic ketoacidosis is more likely to occur when you are sick. Stress hormones secreted in the body when you are sick may raise your blood glucose. If you vomit, you may become dehydrated. Patients may not take their diabetic medications when they have no appetite.
To prevent ketoacidosis when a person with diabetes is unwell, drink plenty of fluids, take your diabetes medicine and eat small meals, and test your blood glucose frequently. If insulin is used, ketone testing is required.
Work with your doctor to develop a plan to prevent a diabetic ketoacidosis emergency before you get sick, and know how to get help.