Ketoacidosis, DKA

Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones.

If you have diabetes or you're at risk of diabetes, learn the signs of diabetic ketoacidosis.

The condition develops when your body can not use glucose (sugar) as a fuel source. When your body cannot produce insulin or not enough insulin, fat is used for fuel instead of sugar. Without insulin your muscles and other tissue cannot function properly. Every cell in the body needs insulin. When fat is used as a fuel source it produces a buildup of acids in the bloodstream called ketones. When ketones build up in the blood, it can be poisonous. This condition is known as ketoacidosis. You should always keep a test for ketones around because if ketones are present, you need to call your doctor right away. Do not delay.

People with type 2 diabetes can develop DKA, but it is less common than in type 1.

DKA usually develops slowly, but when vomiting occurs life-threating conditions can develop.

Early Symptoms Include:

• Thirst and/or a very dry mouth (certain medications can produce a very dry mouth also). Know your medications.
• Frequent urination that lasts for a day or more.
• High blood glucose (sugar) levels - If you are not testing very often, you may not be aware your blood sugar is high. Your doctor runs an HbA1C test to get an approximate idea what your blood sugar has been running for the last three months - This test is a weighted average not an exact average. Other than that, unless you're testing regularly, neither you nor your doctor has any idea what you have been running.
• High levels of ketones in the urine. You can buy ketone testing strips to test for ketones at your pharmacy.

Warning Signs of DKA:

• Constantly feeling tired
• Decreased alertness
• A hard time paying attention, or confusion
• Dry or flushed face and skin
• Deep, rapid breathing
• Fruity-smelling breath
• Headaches
• Muscle stiffness or aches
• Nausea, vomiting (vomiting can be caused by many illnesses, not just ketoacidosis), abdominal pain. If vomiting continues more than 2 hours, contact your doctor.

Know When to Seek Emergency Care:

• Decreased consciousness
• Fruity breath
• Nausea and vomiting
• Trouble breathing

After you enter the hospital the cause of the episode is sought. The most common precipitating factors are: undiagnosed type 1 diabetes, infection, alcohol consumption, GI upset, failure to take your insulin. Type 1 diabetes in childhood characteristically begins suddenly and progresses rapidly. Type 1 diabetes is usually made when the child arrives at the hospital in diabetic ketoacidosis.

With the proper medical attention, DKA is almost always successfully treated. The mortality rate is around ten percent. If you are already in a coma on admission it will affect your prognosis. Most causes of death are: circulatory collapse, hypokalemia, infection, and cerebral edema.

Once DKA is diagnosed, prevention measures to avoid it includes regular monitoring of your blood glucose (sugar), careful administering of insulin, and lifestyle changes. You should monitor your blood sugars more during periods of stress, infection and trauma when the readings typically increase in response to these situations. Test your ketones during these periods or when your sugar level is a lot higher than it normally is..