Diabetic ketoacidosis (DKA) is a severe condition where harmful acidic secretions accumulate in the bloodstream of a person already affected by diabetes. It is characterized by overproduction of acids termed as ketone bodies, which are released into the bloodstream.
In instances of diabetes, the body cannot produce insulin, which is responsible for supplying processed glucose or sugars to cells, for performing biochemical tasks. This leads to energy requirements being met by burning lipids or fats. While metabolizing fats to derive energy, acids called ketones are released in the body.
When excessive fat is burned in the body, it leads to the buildup of blood acids or ketones in the system. This surplus can negatively alter the chemical balance of blood and disrupt the normal functioning of the entire system.
Diabetic ketoacidosis commonly occurs in those who already have type 1 diabetes mellitus, which can sometimes also trigger chest infections, stress-related illnesses and heart problems. DKA only rarely affects those who have type 2 diabetes mellitus.
If left untreated, diabetic ketoacidosis can lead to coma and even prove to be fatal. It is therefore advised to consult a medical professional as soon as certain traits of DKA are displayed by the affected individual.
A person who is already suffering from type 1 diabetes is at a higher risk of DKA and hence must immediately seek medical attention if:
- Blood sugar levels are persistently higher than 300mg/dL.
- Urine ketone levels are moderately high.
- Many signs such as gastrointestinal discomfort, shortness of breath and acetone-like smell from the mouth are all experienced together.
The typical symptoms experienced by a person with diabetic ketoacidosis include:
- Pain in the abdomen
- Frequent thirst
- Fruity scent in-breath (ketone bodies have a characteristic mildly-sweet odour)
- Difficulty in breathing
- Fatigue and dizziness, such as in vertigo
- Nausea and vomiting
- Excessive urination
- Mental confusion
Diagnosis And Treatment:
The healthcare provider or the endocrinologist, who is a doctor specializing in metabolism and hormonal issues, will initially conduct a thorough physical exam to look for indications of DKA in the individual.
He or she will next analyse several parameters by means of laboratory tests, to identify the levels of sugars, ketone bodies and acids in the bloodstream of the patient.
In addition, to probe if any underlying illness or infection is causing DKA, urine examinations, chest x-rays and electrocardiograms may also be carried out.
Once the diagnosis of diabetic ketoacidosis is confirmed, treatment measures are promptly initiated, by hospitalizing the patient.
1. Fluid Replacement:
This procedure is performed either orally (by mouth) or intravenously (through a vein), to replenish the vital liquids lost by the body due to the uncontrolled elimination of urine. Furthermore, this assists in diluting the increased sugar concentrations due to diabetes in the system, thereby controlling blood glucose levels.
2. Electrolyte Replacement:
This technique is also administered intravenously, in order to supply the essential ions, namely sodium, potassium and chloride to the bloodstream, which are lowered due to lack of insulin in the body, causing electrolyte imbalance. This ensures the normal functioning of the heart, nerves and muscles.
3. Insulin Therapy:
This invasive protocol is mandatorily provided, by intravenous means and blood sugar levels are observed closely until they come down to around 200mg/dL. This means that the blood is not highly acidic anymore and normal oral or subcutaneous insulin dosage can be resumed, to keep other factors of diabetes in check.