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• Diabetic ketoacidosis
• Causes that Diabetic ketoacidosis
• Signs and symptoms
• Risk factors
• When should you see a doctor
• Diagnosis
• Treatment of Diabetic ketoacidosis
• How to prevent Diabetic ketoacidosis
• Do assessment to receive your type 2 diabetes risk evaluation

Diabetic ketoacidosis (DKA)

This condition occurs when insulin is severely deficient, leading to poor cellular uptake of blood glucose and cannot contribute as a source of cellular metabolic energy. As a result, fat is broken down and used as metabolic fuel instead, leading to a buildup in the blood of acids called ketones. Left untreated, the buildup of ketones can cause diabetic ketoacidosis.

Individuals who can be affected by the condition include type 1 diabetes patients, those with undiagnosed diabetes, and some people who have ketosis-prone diabetes. DKA can involve individuals of any age. About 20 to 40 percent of patients with DKA are newly diagnosed with type 1 diabetes. Despite its rarity, type 2 diabetes can also be affected by DKA.

What causes diabetic ketoacidosis?

When our cells cannot absorb glucose due to deficient insulin, other counter-regulatory hormones are released to break down fat for energy, leading to excessive ketone production. Urinary tract infections, pneumonia, pancreatitis, and heart attack, among others, can trigger DKA. High levels of adrenaline or cortisol can hinder insulin secretion and possibly lead to DKA. In addition, pregnancy, cocaine or drug abuse, and certain medications like diuretics, corticosteroids, and SGLT2 inhibitors can predispose to DKA.

What are the signs and symptoms of diabetic ketoacidosis?

Symptoms of diabetic ketoacidosis can be present within 24 hours, while some coincide with diabetic symptoms as well; they may include:

• Headache
• Extreme thirst
• Hyperglycemia
• Frequent urination
• Dehydration
• Shortness of breath
• Abdominal pain
• Fruit-scented breath
• Extreme fatigue
• Nausea and vomiting

Risk factors

Factors contributing to the development of DKA include a family history of diabetes and autoimmune diseases and undermanaged type 1 and type 2 diabetes.

when should you see a doctor?

You should seek medical attention immediately if you vomit or cannot keep food or drink down. In addition, if your blood sugar is over 300 mg/dL, emergency treatment is necessary. DKA must not be neglected and left untreated, as the condition can rapidly lead to death.

How is coughing up blood diagnosed?

Doctors diagnose DKA by physical examination and laboratory tests for blood glucose, ketones, pH, electrolytes, urinalysis, CXR, and EKG.

What are the treatments for Diabetic ketoacidosis?

Early detection of DKA at a mild stage allows patients to treat the condition at home with instructions from a doctor. Home remedies for DKA include:

• Follow the doctor's instructions regarding medication and insulin dosage.
• Avoid exercise: Certain physical activities can raise blood sugar and ketone levels.
• Stay hydrated: DKA patients should drink water, sugar-free beverages, or broth to stay hydrated, especially when feeling sick or vomiting.
• Check blood sugar and ketone levels regularly: To check whether the treatment is effective, monitor your blood sugar levels hourly and use a blood ketone meter to check ketone levels.
• Maintain your regular diet: Eat food normally even when not feeling well.

If severe symptoms develop, hospitalization is mandatory. While at the hospital, doctors may give the following treatments:

• Insulin: Given IV or injected into muscles
• IV fluids can help with urinary ketone excretion, treat electrolyte imbalance, and correct dehydration.

Other treatments may be administered, depending on the severity of the condition. In addition, once your blood sugar level is below 200 mg/dL and your blood pH is over 7.3, you are out of the DKA state.

Complications

Complications of diabetic ketoacidosis can be associated with treatment for the condition and include hyperglycemia, elevated ketones, hypokalemia or low potassium level, and cerebral edema or swelling of the brain.

How to prevent Diabetic ketoacidosis?

DKA is preventable by several means, such as:

• Diabetes management: Keep diabetes under control with healthy diets and physical activity.
• Insulin dosage adjustment: Consult your doctor regarding your insulin dosage adjustment to keep your blood sugar in a healthy range.
• Blood sugar and ketone monitoring: Check your blood sugar and ketone levels if you feel sick or stressed. If diabetes patients have high ketone levels, it indicates they need more insulin.
• Do not stop insulin injections without consulting a doctor.

Preparing for your appointment

Despite manifesting mild symptoms of diabetic ketoacidosis, it is crucial to seek medical attention at once. Call local emergency numbers, (1669 in Thailand), if the symptoms worsen or are severe. In addition, a doctor may ask questions to learn about your symptoms and condition. Examples include:

• Can you keep food or drink down?
• Have you checked your blood sugar and ketone recently?
• Do you have diabetes or have you been diagnosed with it?
• When did the DKA symptoms develop?
• How effectively were you managing your diabetes before the onset of DKA symptoms?

A note from MedPark Hospitals doctor

Diabetic ketoacidosis is a life-threatening condition. It is crucial to seek medical attention promptly once the symptoms occur. DKA is much simpler to treat during its early stages. Since diabetes is one of the causes of DKA, diabetes patients must manage their condition well to prevent not only DKA but other diabetes complications.