Diabetic ketoacidosis

Causes and Risks:
In a person with diabetes , if insulin is not present for the body to use glucose as a fuel source, body fat is used as fuel. The by-products of fat metabolism are ketones. Ketones build up in the blood and "spill" over into the urine. A condition called ketoacidosis develops when the blood is more acidic than body tissues. Blood-glucose levels become elevated above 300 mg/dL because of increased production of glucose in the liver and decreased glucose uptake by the cells. Diabetic ketoacidosis may be the first symptom of a person with Type I diabetes; or it may be the result of increased insulin needs in Type I diabetes because of infection, trauma, heart attack , or surgery. People with Type II diabetes usually develop ketoacidosis only under conditions of severe stress . Poor compliance with diet and treatment is usually the cause when episodes are recurrent.

Prevention:
Diabetics should learn to recognize the early warning signs and symptoms of ketoacidosis. Measurement of urine ketones in people with infections or people on insulin pump therapy can give more information than glucose measurements alone.

Symptoms:

Additional symptoms that may be associated with this disease:



Signs and Tests:

This disease may also alter the results of the following tests:



Treatment:
The goal of treatment is to correct the elevated blood-glucose level by the administration of additional insulin, and replace fluids lost through excessive urination and vomiting . Often, a person with diabetes will be able to recognize the early warning signs and make appropriate corrections at home before the condition progresses to coma .

If ketoacidosis is severe, hospitalization is required to control the condition. Insulin replacement will be given, fluid and electrolytes will be replaced, and the cause of the condition (such as infection) will be identified and treated.

Prognosis:
Cell damage from acidosis can lead to severe illness or death. Improved therapy for young diabetics has decreased the death rate associated with ketoacidosis. However, it remains a significant risk in the elderly and in people in profound coma when treatment has been delayed.

Complications:



Call Your Healthcare Provider:
This condition can become a medical emergency. Call your health care provider if you notice early symptoms of diabetic ketoacidosis.

Go to the emergency room or call the local emergency number (such as 911) if nausea , vomiting , fruity breath, mental stupor , hallucinations , difficulty breathing , or decreased consciousness are present.