Diabetic Ketoacidosis: Causes – Treatment

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Diabetic Ketoacidosis (DKA) is a life threatening complication of diabetes which occurs when the cells in the body are not able to acquire sufficient amount of glucose required for energy, due to insulin deficiency.

The body, to compensate for this lack of gulcose, in turn, begins to break down muscles and fat for energy. This leads to production of ketones or fatty acids which enters the bloodstream, creating chemical imbalance known as diabetic ketoacidosis.

DKA can occur in people suffering with either type 1 or type 2 diabetes but it is more common in type 1 diabetes. There are chances that DKA may even occur if you are at a risk for diabetes and have not yet been formally diagnosed as diabetic. Males and females are equally affected by DKA.

DKA is a medical emergency, the moment this complication is suspected; you need to immediately contact your physician. This complication can lead to diabetic coma or even death.

Risk Factors

Suffer with Type 1 diabetes.
Frequently miss your insulin doses.
Are under the age of 19.
Have high temperature.
Have stress or are exposed to some form of trauma (physical or emotional).
Have had a stroke or heart attack.
Are undergoing severe stress.
Smoke or drink alcohol.

Causes

DKA can be generally triggered by the following causative factors

Insufficient production of insulin.
Severe infection or other illness.
Severe dehydration.
Missed insulin treatment.
Medications such as corticosteroids and few diuretics.

Symptoms

DKA develops very rapidly, sometimes even within 24 hours. Symptoms experienced in diabetic ketoacidosis are as follows

Increased thirst.
Increased frequency of urination.
Fatigue.
Appetite reduced.
Confusion.
Vomiting.
Pain in abdomen.
Increased heart rate.
Decreased blood pressure.
Dry mouth.
Dry skin.
Fruity odor in breath.
Shortness of breath.
Increased blood sugar levels.
Increased ketone levels in urine.

Diagnosis

Some of the tests required to confirm the diagnosis of DKA include

Blood glucose.
Ketones in urine & blood.
Arterial blood gas, to determine the acidity of blood.
Serum urea & serum creatinine, to determine the health of kidney.
Blood electrolytes.
Serum amylase, to determine the pancreatic function.
Chest X-Ray, to determine pulmonary signs of infection.
ECG.
CT & MRI, to detect early cerebral oedema.

Treatment

Fluid replacement – Until the patient is rehydrated, fluids will be given either through the veins or mouth.
Electrolyte replacement – Levels of various electrolytes in the blood are lowered due to absence of insulin. To balance the requirement, electrolytes are given through a vein.
Insulin therapy – Insulin therapy is given through a vein. Insulin helps in reversing the processes which cause diabetic ketoacidosis and in suppressing the production of ketones.