Diabetic Ketoacidosis (DKA)
Diabetic ketoacidosis, also called diabetic coma.
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A life-threatening condition that can occur in patients with diabetes mellitus. |
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It is caused by failure to take insulin or anything that increases the body's need for insulin, as infection, surgery, injury, or stress. |
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Warning signs include a dull headache, fatigue, extreme thirst, pain below the breastbone, nausea, dry lips, sunken eyes, and a fruity breath odor. The temperature usually rises and then falls. |
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The ketoacidosis is a medical emergency. The person should be taken to a hospital as soon as symptoms develop. |
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Immediate treatment is to give insulin and replace fluids to help dehydration. |
Diabetic ketoacidosis is a metabolic disorder consisting of three major abnormalities:
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Elevated glucose level. (hyperglycemia). |
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High ketone bodies in blood. (hyperketonemia) |
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Metabolic acidosis. |
Dehydration and hyperosmolarity are usually present.
Precipitating factors for Diabetic ketoacidosis (DKA).
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DKA develops due to either an absolute or a relative absence of insulin. |
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In Type 2diabetes, it is usually a relative lack of insulin, whereas in Type 1diabetes there is an absolute absence of insulin. |
Causes of Diabetic ketoacidosis
Absolute lack of insulin
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Type 1 diabetes |
Relative lack of insulin
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Acute illness :Infection, trauma, stroke, heart attack. etc. |
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Endocrine disorders. |
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Drugs like steroids, beta blockers, alcohol etc. |
Clinical features
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Polyuria (increased urination). |
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Polydipsia (increased thirst). |
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Weight loss. |
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Anorexia (decreased appetite). |
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Nausea and /or vomiting. |
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Abdominal pain. |
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Dehydration. (sunken eye balls, dry tongue, reduced tissue turgor). |
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Shock. |
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Hyperventilation (increased respiration-Kussmaul's breathing). |
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Smell of ketone. (chemical substance formed in body in Diabetic ketoacidosis) |
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Precipitating illness like infections etc. |
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Confusion and later on coma (5-10%). |