What is Diabetic Ketoacidosis?: Signs, Symptoms, Causes and Treatment
What is diabetic ketoacidosis?
Diabetic ketoacidosis (DKA) refers to a serious diabetes complication which happens when your body produces high amount of blood acids known as ketones. It is a very serious medical condition that could lead to diabetic coma or death. This life threatening medical condition happens when the body cells are unable to get the glucose they need for energy, because of a deficiency in insulin. Insulin is a hormone that helps glucose, a main source of energy for muscles and tissue, enter the body cells. When glucose cannot get into the body cells, it remains in the blood. The kidney will then filter some of the glucose from the blood, then excrete it from the body through the urine. When your body cells do not receive energy from glucose, they start to break body fat down into energy. When that happens, fatty acids or ketones are produced which then enter the bloodstream. This will lead to a chemical imbalance that causes DKA.
Diabetic ketoacidosis mostly affect people with type 1 diabetes, but can also occur in people with type 2 diabetes. The reason for this is because people with type 1 diabetes cannot produce enough insulin on their own. Lack of insulin allows your blood to become acidic. Because your body cells cannot make it under acidic conditions, the liver will secrete glucose to help the starving cells. Research shows that there are over 200,000 cases of patients suffering from DKA every year in the US alone.
Diabetic ketoacidosis signs and symptoms
There are signs and symptoms you can look out for to know if you have diabetic ketoacidosis. These signs and symptoms usually develop quickly and could indicate you have diabetes. If you are experiencing symptoms of DKA, you need to call your doctor immediately. If not treated, DKA can be fatal. If this condition is diagnosed early, it can be treated with extra fluid, glucose and insulin.
Symptoms of DKA include:
- Abdominal pain
- Low blood pressure
- Increased heart rate
- Nausea or vomiting
- Frequent urination
- Extreme thirst
- Rapid breathing
Causes of DKA
Ketoacidosis could be caused by having a severe infection or illness, being severely dehydrated or not getting enough amount of insulin. Missing your dose of insulin can leave you with small amounts of insulin, which canlead to diabetic ketoacidosis. You can use an alarm to remind you to take your insulin dose. Glucose is one of the main source of energy for our body cells. Insulin helps sugar get into the body cells. If there is less sugar, our body cannot properly utilize sugar for energy. As a result, fat will be broken down by hormones, which leads to blood acids. Therefore, if our food lacks insulin, it increases our risk of getting DKA.
Your risk of contracting diabetic ketoacidosis increases during illness because the stress hormone released, increases your blood sugar. These stress hormones may also negate the effect of insulin which leads to periods of DKA. When you are sick, you need to check your blood sugar and ketone levels after every 2 hours. Therefore, if you are not feeling well, you can take food or drink water to prevent the risk of contracting DKA. Make sure you regularly test your blood sugar. In case the blood sugar level is above the normal range, you should medical advice.
Just like adults, DKA in children is caused by deficiency in insulin. Reports show that this medical condition is one of the biggest causes of deaths and severe morbidity in diabetic children.
Diabetic ketoacidosis can be diagnosed through lab tests such as urine and blood tests.Keep the test kits close by so in case you experience high levels of blood sugar. There are test kits that you can use at home. If the home urine test detects ketones in your urine, you need to contact your doctor who may order further testing. Make sure you conduct home urine tests for ketones when you are highly stressed or ill. This will help you identify moderate ketones before they can become life threatening.
The common tests your doctor may conduct include blood sugar level and blood acidity tests. Your doctor may also test your arterial blood gas to check your blood acidity. In addition, they will carry out chest X-ray to determine signs of infection. In case you are diagnosed with diabetic ketoacidosis but have not yet been diagnosed with diabetes, your healthcare provider will come up with a treatment plan to help you prevent a recurrence of ketoacidosis. Once you are diagnosed with DKA, you will be treated in the emergency room or hospital.
The treatment plan will include:
- Intravenous insulin therapy
- Intravenous electrolyte replacement
- Intravenous oral fluid replacement.
Diabetic acidosis should be treated under close supervision of a doctor. In case of severe acidosis, it should be treated in a hospital or emergency room. Treatment usually involves giving patients fluids and insulin through the vein. Insulin helps to lower the level of blood sugar while intravenous fluids restores proper levels of water lost as a result of dehydration. As a treatment, insulin will be administered intravenously so as to keep your blood glucose levels below 240 mg/dL. Once the right range of blood glucose level is attained, you should closely work with your doctor to prevent the risk of diabetic ketoacidosis occurring in future.
Electrolytes are also used to restore the imbalance caused by dehydration. When insulin levels fall below the normal range, the level of electrolytes will fall abnormally low. Electrolyte replacement treatment will be conducted to help your body and nerves function properly. Your doctor will monitor you closely to ensure your brain does not swell as a result of fluids taken to treat dehydration. Other than treatment, you can take various preventive measures to avoid the risk of contracting DKA. Have insulin in the right amounts and drink lots of unsweetened fluid.
DKA in animals
The disease may also affect animals such as cats and dogs. When a diabetic cat or dog goes through periods of stress, their body will produce a stress hormone which interferes with insulin activity. This will in turn lead to DKA. Dogs which are diagnosed with this medical condition can be treated through IV fluid treatment. A short acting insulin is given to cats so as to bring their blood sugar level down. Diabetic ketoacidosis in cats and dogs is avoidable. You will need to monitor their blood glucose levels at home or seek assistance from a veterinary officer.
Disclaimer: Please note that the contents of this community article are strictly for informational purposes and should not be considered as medical advice. This article, and other community articles, are not written or reviewed for medical validity by Canadian Insulin or its staff. All views and opinions expressed by the contributing authors are not endorsed by Canadian Insulin. Always consult a medical professional for medical advice, diagnosis, and treatment.