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Diabetic ketoacidosis (also called diabetic acidosis) is a serious complication of diabetes that occurs when the body produces an excess of acids called ketones.
This condition occurs when the body can not produce enough insulin. Insulin plays a vital role in the metabolism of sugars (glucose), which are the primary source of energy for muscles and other tissues. Without enough insulin, the body begins to break down fats as fuel, and this process causes the formation of excessive amounts of acids (ketones) in the bloodstream, leading to diabetic ketoacidosis.
People with diabetes are at risk of ketoacidosis. Therefore, it is crucial to take care of prevention and treatment of it.
The causes of diabetic ketoacidosis
Diabetic ketoacidosis interferes with insulin function of the body, reducing the secretion of the hormone. As a result, the body begins to secrete other hormones that break down fat for fuel acquisition for the body, which contributes to the overproduction of acids called ketones. Excess buildup of ketones in the blood eventually goes into the urine.
Diabetic ketoacidosis is most often caused by:
- diseases and infections (such as infections of lungs and urinary tract) that affect the elevated levels of certain hormones such as adrenaline or cortisol; these hormones, in turn, limit the action of insulin, which over time can lead to acidosis;
- problems with insulin therapy – inappropriate insulin treatment may cause, that its deficiency leads to the appearance of disorder;
- physical or emotional trauma;
- heart attacks;
- the consumption of excessive quantities of alcohol or other substances of abuse like drugs (mainly cocaine);
- use of some medicines like corticosteroids and certain diuretics.
Among the factors that increase the risk of ketoacidosis is type I diabetes, skipping doses of insulin, much less frequently is type II diabetes. Diabetic ketoacidosis can also be the first symptom that a person suffers from diabetes.
The symptoms of ketoacidosis
In diabetics, the symptoms of ketoacidosis can manifest themselves often suddenly, because it develops quickly – sometimes within just 24 hours. Among the first symptoms include:
- excessive thirst,
- frequent urination,
- nausea and vomiting,
- stomach pain,
- weakness or fatigue,
- shortness of breath,
- fruity breath odor,
The symptoms detectable through blood tests and urine tests are:
- high blood sugar levels – hyperglycemia,
- elevated levels of ketones in urine.
Immediate contact with your doctor is necessary when:
- the patient has constant vomiting and does not tolerate any food or liquids,
- blood sugar levels are higher than normal and do not decrease in spite of previously used methods of treatment,
- levels of ketones in the urine are moderate or high.
Untreated ketoacidosis can be fatal if left untreated!
Diabetic acidosis can also affect other substances in the body as electrolytes – sodium, potassium or chloride. Complications of acidosis, sometimes, unfortunately, a very common are associated with the treatment of emergency. Among them are:
- a low blood sugar – hypoglycemia;
- low blood potassium – hypokalemia, which weakens the action of the heart, muscles, and nerves;
- edema of the brain;
- loss of consciousness;
- in extreme cases, even death.
Diagnosis and treatment of diabetic ketoacidosis
A general medical examination and various blood tests help determine the cause of diabetic ketoacidosis. They can also be tests such as chest X-ray, ECG, or urine test.
The treatment typically involves the administration of replacement fluid – either orally or intravenously, to achieve adequate hydration. They replace the fluids that were lost as a result of excessive urination, and an additional help dilutes the excess sugar in the blood.
Shall also apply to the exchange of electrolytes, which can maintain healthy functioning of the heart, muscle and nerve cells. Additionally, is administered insulin, which helps to reverse the processes that cause the ketoacidosis.
Depending on the causes of acidosis, a doctor recommends an additional new treatment plan for diabetes, antibiotics to treat infections or directs for further tests such as assessing heart function after myocardial infarction.