Diabetic Ketoacidosis (DKA) is a very serious complication of diabetes in which the body burns fat at a very high rate. As a result, the level of acids known as ketones increases in the blood. It might be the first symptom that manifests in a person diagnosed with Type 1 diabetes. It can also rarely occur in Type 2 diabetic people.
Diabetic Ketoacidosis occurs primarily in Type 1 diabetes. The body produces insulin less than the required amount, and as a result, the energy generated from the breakdown of glucose in the blood is insufficient. To compensate for this inadequacy, the liver draws energy from the fat in the body by converting it to ketones. In biochemical terms, Diabetic Ketoacidosis is defined as the increase in serum concentration of ketones more than 5 milliequivalents per litre, increase in blood sugar levels to more than 250mg/dL and a blood pH less than 7.3.
High levels of ketones in the blood cause a chemical imbalance in the body, it makes the blood acidic. The body gets rid of the excess ketones in the blood through urine, but this process is not enough and as a result, ketones build up in blood eventually. This abundance of ketones in the blood can lead to loss of consciousness, and eventually death.
Diabetic Ketoacidosis Risk Factors
Diabetic Ketoacidosis is much prevalent among the people of the below-mentioned risk factors:
- Type 1 Diabetic
- Under the age of 19
- Have had heart diseases like heart attack, strokes
- Recent pregnancy
- Drug or alcohol usage
- A blood clot in the lungs
- Underwent physical or emotional trauma
Diabetic Ketoacidosis Symptoms
Diabetic Ketoacidosis can be identified with symptoms like:
- Frequent urination (polyuria)
- Increased thirst (polydipsia)
- Dryness in skin and mouth
- Stomach ache
- Shortness of breath
- Sweet-scented breath
The symptoms usually start to appear rapidly.
Diabetic Ketoacidosis Causes
- Diabetic Ketoacidosis occurs when the body cannot derive enough energy from the breakdown of glucose and thus resorts to burning fat. The burning of fat creates ketones as a by-product. This increases the acidity of the blood.
- An illness or infection can induce the secretion of hormones like adrenaline and cortisol. These hormones can counter the effect of insulin and cause diabetic ketoacidosis. Some of the major infections which cause Diabetic Ketoacidosis are pneumonia and urinary tract infections.
- Diabetic Ketoacidosis can also be a result of missing insulin intakes, insufficient insulin therapy or a malfunctioning insulin pump which leaves the body with inadequate insulin.
- Skipping meals can also increase the ketone levels in the blood.
Diabetic Ketoacidosis Diagnosis
The levels of ketones must be checked if the blood glucose level rises above 240mg/dL or any of the aforementioned symptoms are exhibited.
- Urinalysis is the primary test for checking the ketone levels in the blood. Urine test strips can be used to perform this.
- Blood tests are required to monitor the blood glucose level, ketone concentration in blood and blood pH. A low pH and high blood sugar level indicates Diabetic Ketoacidosis. It is also taken to analyse the overall health of the patient by checking for levels of electrolytes, namely potassium and sodium.
- Tests are conducted for identifying any signs of infection and if positive, additional tests like an electrocardiogram, chest X-rays can be recommended.
- An arterial blood gas test can be taken to check the pH of blood in the arteries.
Diabetic Ketoacidosis Complications
Diabetic Ketoacidosis can cause serious health complications if left unchecked. A few of them include:
- Low blood sugar (hypoglycemia)
- Low potassium (hypokalemia)
- Swelling of the brain (cerebral oedema)
- Loss of consciousness
Diabetic Ketoacidosis Treatment
Diabetic Ketoacidosis can push a person into a coma and might even be fatal in extreme cases. It becomes crucial to lowering the levels of ketones as soon as possible. The objective of the treatment must be to normalize the pH of blood while bringing down blood sugar level and tackling electrolyte imbalance. The following methods are equipped for Diabetic Ketoacidosis treatment.
- Insulin is injected through an IV to bring down the ketone level in the blood.
- Diabetic Ketoacidosis causes an acute imbalance in the chemical composition of the body, especially potassium. The fluctuating levels of electrolytes must be monitored and deficient electrolytes must be replaced. Other minerals like sodium and chloride are also regulated through electrolyte IV for the proper functioning of the heart, muscles and nerves.
- IV fluids are injected into the person to keep them hydrated and replace fluid loss. The amount and speed at which the IV fluids are infused are important factors in the treatment.
- Antibiotics are supplied in case of any infections.
Diabetic Ketoacidosis Prevention
Prevention is better than cure and it is highly appropriate in the case of DKA. Diabetic Ketoacidosis is a very serious condition and every person with the risk factor of obtaining this complication must take the necessary precautions to avoid this deadly condition.
- When suffering from diabetes, the medicines prescribed by the doctor must be taken regularly.
- Insulin intakes must never be skipped. The insulin-infusion devices must be checked regularly and the insulin itself must be checked for expiry.
- A balanced diet with healthy food and regular exercise can help keep the blood sugar level at the right amount.
- Regular monitoring of blood sugar levels must be done. Ketone levels must be tested with the appearance of symptoms.
Diabetic Ketoacidosis disrupts the chemical balance of the human body and thus is a fatal condition. Necessary care must be taken to prevent it at all costs, which requires proper monitoring of blood sugar levels, ketones and pH.