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Diabetic Ketoacidosis – Symptoms, Causes, Treatment

Updated on October 3, 2013

Diabetic ketoacidosis is a dangerous and often fatal complication of diabetes. It is caused due to elevated quantities of blood acids or ketones produced by the body, which eventually gets released into the bloodstream.

Diabetic patients should ensure that they are aware of the varied signs and symptoms of diabetic ketoacidosis. This will allow them to be fully prepared and seek immediate medical assistance when needed.

Diabetic Ketoacidosis - Symptoms

The signs and symptoms associated with diabetic ketoacidosis usually have a rapid onset, often within 24 hours. A few symptoms are listed below:

  • Elevated levels of thirst
  • Frequent urination
  • Nausea and vomiting
  • Loss of appetite
  • Exhaustion, fatigue, and/or weakness
  • Abdominal pain
  • Shortness of breath
  • A fruity odor to the breath
  • Confusion or disorientation

Patients may also keep blood and urine test kits at home. This will allow them to verify the more specific signs like elevated levels of ketones in urine and elevated blood sugar levels.

The symptoms that accompany diabetic ketoacidosis may mimic the signs of flu. This can pose problems in effective diagnosis. Hence, all patients of diabetes need to regularly monitor their blood sugar levels when they feel unwell or ill. Home aid kits to check ketone levels in urine are also very helpful.

Diabetic Ketoacidosis -Complications

Diabetic ketoacidosis is treated via intravenous administration of electrolytes like sodium, potassium, and chloride, and other fluids. Such treatment can then give rise to certain complications as listed below:

  • Low blood sugar or hypoglycemia: It is a dangerous condition. Administration of insulin causes sugar to enter the cells. This causes the levels of sugar in blood to drop. A rapid drop in blood sugar levels can also occur during treatment of diabetic ketoacidosis.
  • Low potassium or hypokalemia:Treatment of diabetic ketoacidosis via administration of fluids and insulin can result in alarming drop of potassium levels in the body. This can then impair the cardiac, muscle, and nerve functionalities.
  • Brain swelling or inflammation/cerebral edema: Rapid balancing of blood sugar levels can have an adverse effect on the brain and cause it to swell up. This dreaded complication of diabetic ketoacidosis typically affects children, especially those who have been recently diagnosed with diabetes.

Diabetic Ketoacidosis - Causes

Diabetic ketoacidosis is caused due to an extreme drop in the levels of insulin present in the body. Insulin plays an essential role in the passage of sugar or glucose into the varied cells in the body. It may be noted that glucose is a vital and most common source of energy for different body tissues, particularly the muscles.

When the insulin levels in the body become deficient, sugar can no longer be efficiently used as an energy source. This causes the body to look for alternate sources of energy. The body then releases certain hormones which allows it to convert fat into energy.

The abnormal process of fat breakdown into energy results in the secretion of toxic acids called ketones which are subsequently passed into the blood stream and later removed via urine. When high levels of ketones in blood and urine are left untreated, it can eventually lead to diabetic ketoacidosis.

There are many factors which can trigger an episode of diabetic ketoacidosis, including:

  • Problems of insulin therapy like missed intake of insulin, or lowered insulin intake can lead to reduced insulin levels in the blood. This can then trigger an instance of diabetic ketoacidosis.
  • An underlying illness or presence of certain types of infections can prompt the body to produce additional hormones such as adrenaline in the body. Hormones are known to counter the effects of insulin and hence excessive hormone levels can then trigger an episode of diabetic ketoacidosis. Pneumonia and UTIs are some of the most common types of causative infections and illnesses.

There are many other factors which can increase the risk to developing diabetic ketoacidosis, as listed below:

  • Physical or emotional upheavals
  • Elevated stress
  • Fever with high temperatures
  • Heart attack
  • Surgery
  • Alcohol or drug abuse
  • Stroke

Diabetic Ketoacidosis Treatment

Diabetic ketoacidosis is a life-threatening condition that can lead to loss of consciousness and even death. It is therefore vital to immediately treat all cases of diabetic ketoacidosis. Treatment involves hospitalization and emergency care.

Treatment of diabetic ketoacidosis is carried out in the below discussed three steps:

  • Insulin is administered intravenously so as to offset the effects of diabetic ketoacidosis. The process continues till the blood sugar levels reduce to under 240 mg/dL, and the ketone content in blood becomes normal.
  • Nil or reduced levels of insulin can result in lowering of electrolyte composition in the body. Therefore, electrolytes are intravenously administered to the patient so as to continue the normal functioning of the muscles, nerves, and heart cells.
  • Fluids may be administered orally or intravenously till the time the patient’s body is fully rehydrated. This process will also help in dilution of sugar levels in blood.

After the patient is stabilized, the physician will check for the causes of diabetic ketoacidosis and then prescribe further treatments to resolve the underlying condition.


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