Diabetes Ketoacidosis is a potential and life-threatening complication found in patients having diabetes mellitus. Diabetes Ketoacidosis mainly develops in the patients with type 1 diabetes, but it may also occur in the patients with type2 diabetes in certain circumstances. Diabetes Ketoacidosis occurs due to the shortage of insulin, because of which the body starts burning the fatty acids and produces ketones, which produces most of the complications and symptoms of Diabetes Ketoacidosis.
Diabetes Ketoacidosis may occur in people having diabetes, which may be a result of many causes, such as poor compliance with insulin therapy or incorrect illness. It is differentiated from the other forms of ketoacidosis by the presence of high blood sugar in the body fluid. Diabetes Ketoacidosis may show some typical symptoms like dehydration, confusion, vomiting, harsh-breathing. The treatment of Diabetes Ketoacidosis involves the correction of dehydration with intravenous fluids, suppression of the production of ketones in the body with insulin, treatment for underlying complication, such as any infection. Diabetes Ketoacidosis was described first in the year 1886. Until the insulin therapy was introduced in the decade of 1920, Diabetes Ketoacidosis had been universally the most fatal.
SYMPTOMS: The symptoms of Diabetic Ketoacidosis generally evolve over a period of 24 hours. Early symptoms of Diabetic Ketoacidosis are:
- Excessive urine production.
- Abdominal pain, which can be severe.
- Excessive thirst.
Laboured breathing of deep, gasping character (it is referred as ‘Kussmaul respiration’ and occurs in severe Diabetes Ketoacidosis). Acute abdomen like acute appendicitis, pancreatitis may be observed. Due to the erosion of oesophagus, coffee ground vomiting (vomiting of altered blood) may occur in some people. In severe Diabetes Ketoacidosis, lethargy, confusion, a marked fall in the conscious level or even coma may be observed. Dehydration, such as a dry mouth and decrease in skin turgor may be found on physical examination. If a decrease in circulating blood volume is caused by dehydration, hypotension and tachycardia (faster heartbeat) may be observed.
Children having Diabetes Ketoacidosis are more prone to the swelling of brain tissue (celebral oedema), which may show the following symptoms:
- Loss of the pupilary light reflex.
- Progress to death.
0.3-1.0 percent Diabetes Ketoacidosis developed children show the above symptoms and they are also found in young adults, whereas they are rarely found in adults. It may carry 20-50 percent mortality.
CONSEQUENCES IF NOT TREATED: Diabetes Ketoacidosis is a severe medical emergency and negligence in treatment may be fatal.
RECOMMENDATIONS: Diabetes Ketoacidosis attacks in the patients having diabetes, may be somewhat prevented by the application of ‘sick day rules’. They who are having diabetes are given clear-cut instructions about treating themselves when they are unwell. The instructions include easy digestible foods that are rich in salt and carbohydrates, ways to control fever and treatment of infections, advice on the extra intake of insulin when the level of sugar appears uncontrollable and recommendations for the situation for which they should call for a medical help.
The treatment of Diabetes Ketoacidosis aims at replacing lost fluids and electrolytes while suppressing ketone production in the body with insulin and high blood sugar. An admission to the intensive care unit for minute observation may become necessary.