This book describes Diabetic Ketoacidosis, Diagnosis and Treatment and Related Diseases
Just recently I had a patient who complained of light-head-ness and confusion.
She had deep, rapid breathing with abdominal discomfort.
I thought she may be having a transient ischemic attack.
Her blood pressure was normal but her blood sugar was found to be very high (524mg/dl).
I quickly advised her relatives to bring her to the hospital.
Later they came back and told me that she was having diabetic ketoacidosis and was admitted to the intensive care unit for treatment.
Fortunately the doctors managed to bring her high sugar down and correct her ketoacidosis
Diabetic ketoacidosis (DKA) is a medical emergency with a considerable disease and death rate.
Diabetic ketoacidosis happens when the cells in the body do not receive the glucose they require for energy.
This happens while there is a lot of glucose in the bloodstream, but not enough insulin to help change glucose for use in the cells.
The body identifies this and begins breaking down muscle and fat for energy.
This breakdown forms ketones (also termed fatty acids), which produce an imbalance in the electrolyte system causing the ketoacidosis (a metabolic acidosis).
The glucose that cannot be used due to the lack of insulin remains in the bloodstream (rather than going into the cell and supply energy).
The kidneys filter some of the glucose and pass it out in the urine.
Diabetic ketoacidosis (DKA) is a severe complication of type 1 diabetes and, much less often, of type 2 diabetes.
DKA happens when the blood sugar is very high and acidic substances termed ketones build up to dangerous levels in the body.
Ketoacidosis should not be confused with ketosis which is not harmful.
Ketosis can happen as an effect of a very low carbohydrate diet, termed a ketogenic diet or fasting.
DKA only happens when the patient does not have sufficient insulin in the body to process high levels of glucose in the blood.
It is less frequent in people with type 2 diabetes since insulin levels do not normally drop so low.
DKA may be the first sign of type 1 diabetes, as people with this disease cannot make their insulin.
Generally diabetic ketoacidosis happens when there is not sufficient insulin to move glucose into the cell where it can be used for energy.
Besides inadequacy of insulin, certain body stress factors combined with diabetes, such as infection or illness, can activate diabetic ketoacidosis.
Occasionally diabetic ketoacidosis is the first sign of diabetes in people who are not conscious they have diabetes.
The most frequent causes of DKA are:
Missing an insulin injection or not injecting enough insulin
Illness or infection
A blockage in one's insulin pump (for people who are using one)
Risk factors for developing diabetic ketoacidosis
People with type 1 diabetes who are not taking their insulin or are becoming sick with an infection or other disease are at danger for diabetic ketoacidosis.
Normally it happens in people who have type 1 diabetes that are at danger for diabetic ketoacidosis.
While it is infrequent in people with type 2 diabetes, it can happen.
DKA happens when blood sugar levels become very high and the insulin levels are low.
The human body requires insulin to use the existing glucose in the blood.
In DKA, glucose cannot get into the cells, so it builds up, causing high blood glucose levels.
In response, the body begins breaking down fat into a usable fuel that does not need insulin.
That fuel is termed ketones.
When too many ketones accumulate, the blood becomes acidic.
This is called diabetic ketoacidosis.
TABLE OF CONTENT
Introduction
Chapter 1 Diabetic Ketoacidosis
Chapter