Diabetic ketoacidosis is a common acute complication in diabetic patients, and since the introduction of insulin, the death rate has decreased significantly from 60% in the past to less than 1% at present. However, in case of severe stress or improper treatment, this complication can still directly threaten the life of the patient. The following is an introduction to ketoacidosis.
I. What is diabetic ketoacidosis?
Diabetic ketoacidosis is an acute complication of diabetes caused by a severe deficiency of insulin produced by the body and is therefore common in patients with type 1 diabetes. Under normal circumstances, the body burns carbohydrates (or what we call staple foods to be broken down into glucose) to provide energy, but due to the lack of insulin in the body, glucose cannot be used to produce heat, so the body can only “burn” fat and protein to ensure the body’s energy needs. The byproduct of this process of fat breakdown is ketone bodies, which are acidic substances, and with the accumulation of ketone bodies, the body will eventually become acidotic. Therefore, the duration of diabetic ketoacidosis usually ranges from a few days to a few weeks, and a few young people can become comatose a few hours after the onset of acidosis due to the obvious acidosis. If the arterial blood gas analysis shows metabolic acidosis (which is judged by the doctor), elevated blood ketone bodies and positive urine ketone bodies, the diagnosis of ketoacidosis can be confirmed.
2. What are the causes of diabetic ketoacidosis?
1. For type 1 diabetes mostly occurs due to insulin interruption, insufficiency or insulin failure.
Type 1 diabetes mostly occurs in the following stressful situations.
(1) Various infections. The most common are influenza and gastroenteritis, but also include lung infections, urinary tract infections, acute pancreatitis, cholecystitis pelvic inflammatory disease, etc.
(2) Stress caused by acute myocardial infarction, heart failure, trauma, burns, surgery, anesthesia, severe mental stimulation, etc.
(3) Poor dietary control Diabetic patients suffer from hyperglycemia caused by lack of diabetic knowledge, lax dietary control, over-eating carbohydrate fat, excess nutrition and alcoholism. High blood sugar can promote lipolysis and produce ketone bodies, and the accumulation in the body produces acidosis.
4.Spiritual factors: Patients are under strong mental stimulation
High mental tension, overexcitement, or excessive irritation and excitement will cause sympathetic excitement and secretion of excessive glucose hormone, which will lead to ketoacidosis due to elevated blood sugar and lipolysis.
What is the danger of diabetic ketoacidosis?
1. In acidosis, blood sugar will rise significantly and a large amount of glucose will be excreted with urine. When glucose is excreted from urine, a large amount of water will be taken away. If water is not replenished in time, dehydration will occur and shock can occur in serious cases.
2. In acidosis, all organs are equivalent to soaking in acid, which will cause continuous damage to organs. In addition, when the blood becomes acidic due to ketone bodies, the body begins to adjust electrolytes to neutralize the acidity. At this time, the body retains sodium and excretes potassium, resulting in a decrease in blood potassium. The decrease in potassium concentration can affect the rhythm of the heart, and severe hypokalemia can lead to cardiac arrest.
Fourth, diabetic patients with those manifestations should consider the possibility of ketoacidosis?
1. Diabetic symptoms worsen, with extreme thirst, excessive drinking, polyuria and wasting.
2. Loss of appetite, nausea, vomiting and abdominal pain (but often without diarrhea).
3. Deep and long breathing with rotten apple odor in the exhaled gas.
4.Dizziness, headache, confusion, drowsiness and extreme weakness.
V. How to prevent diabetic ketoacidosis?
First of all, it is important to understand the specific triggering factors of diabetic ketoacidosis, so that eliminating and avoiding these factors can effectively prevent the occurrence and development of diabetic ketoacidosis. Secondly, it is important to monitor blood glucose frequently, understand the changes in blood glucose, and increase or decrease drugs in time to keep blood glucose stable. Any condition that can cause severe insulin deficiency in the body can trigger diabetic ketoacidosis, so do not stop using hypoglycemic drugs and insulin without authorization. Once again, when you find that your blood glucose is elevated, you should check your urine routine in a timely manner. Go to the hospital or contact your doctor promptly when ketone bodies appear in urine. Further treatment will be guided by the doctor’s instructions.