Diabetes Management
The Dangers of Diabetic Ketoacidosis
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By Apollo 24/7, Published on- 05 January 2021, Updated on - 18 October 2022
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What is diabetic ketoacidosis?
What are the early warning signs of diabetic ketoacidosis?
- Extremely dry mouth with thirst
- Frequent urination
- Blood glucose levels above 240 mg/dL
- High levels of ketone bodies in the body (can be checked in either urine or blood)
- Pain in the abdomen
- Nausea and vomiting that continues for more than 2 hours
- Weakness and fatigue
- Dry, flushed skin
- Fruity breath that might resemble a nail-polish remover
- Heavy and laboured breathing (also called Kussmaul breathing)
- Mental confusion, irritability and inability to concentrate
- Slurring of speech
- Blurring of vision
- Swelling of the brain, which can make the person feel drunk and behave irrationally.
What causes diabetic ketoacidosis?
- Lack of insulin in the body, either due to missed insulin dose or due to the increased demand of insulin in the body, can trigger ketoacidosis.
- Adverse reaction to insulin can also increase the levels of ketone bodies in the blood.
- Skipping food frequently can increase the levels of ketone in the body.
- Acute infections such as pneumonia or urinary tract infection.
- Medical emergencies such as heart attack or stroke can trigger physiologic stresses in the body, resulting in low insulin production, thereby increasing ketone levels.
- Ketone levels can also spike during pregnancy.
- Use of certain drugs such as corticosteroids, thiazide diuretics, sympathomimetics and sodium-glucose co-transporter 2 (SGLT-2) inhibitors can also trigger ketoacidosis in diabetic people.
Can this dangerous condition be prevented?
- Regular monitoring of blood sugar levels, especially in times of stress or illness.
- Following a strict insulin regimen to make sure that the sugar levels are under control. Discuss with your doctor when and how to increase or reduce the dose of insulin.
- Following the diet and exercise pattern recommended by the endocrinologist and dietician rigorously.
- Checking for ketone bodies with either blood or urine ketone test kit. It is advised to check for ketone bodies every 4 to 6 hours when sugar level spikes to 240 mg/dl or when the person is suffering from an infection (such as cold or flu).
How can diabetic ketoacidosis be treated?
- D: Family/ previous history of diabetes or increased blood sugar levels
- K: Presence of ketone bodies in the urine or blood
- A: Higher levels of acid in the blood
- The patient is given a large volume of fluids intravenously (through the vein) to treat dehydration and to neutralise the acid levels.
- The patient is also given insulin intravenously, one to two hours after the fluids are administered, to lower the blood sugar levels.
- Potassium supplements are given to treat hypokalemia, which is one of the reasons for diabetic ketoacidosis.
- Blood sugar levels, fluid status, acid levels, cardiac status, urine output, blood pressure and electrolyte levels are monitored closely.
- The patient is given antibiotics or other medications in case of any infection that would have triggered ketoacidosis.
Conclusion
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