About diabetic ketoacidosis (dka)
What is diabetic ketoacidosis (dka)?
Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones.
The condition develops when your body can't produce enough insulin. Insulin normally plays a key role in helping sugar (glucose) — a major source of energy for your muscles and other tissues — enter your cells. Without enough insulin, your body begins to break down fat as fuel. This process produces a buildup of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated.
If you have diabetes or you're at risk of diabetes, learn the warning signs of diabetic ketoacidosis and when to seek emergency care.
What are the symptoms for diabetic ketoacidosis (dka)?
More-specific signs of diabetic ketoacidosis — which can be detected through home blood and urine testing kits — include:
- High blood sugar level
- High ketone levels in your urine
What are the causes for diabetic ketoacidosis (dka)?
Sugar is a main source of energy for the cells that make up your muscles and other tissues. Normally, insulin helps sugar enter your cells.
Without enough insulin, your body can't use sugar properly for energy. This prompts the release of hormones that break down fat as fuel, which produces acids known as ketones. Excess ketones build up in the blood and eventually "spill over" into the urine.
Diabetic ketoacidosis is usually triggered by:
- An illness. An infection or other illness can cause your body to produce higher levels of certain hormones, such as adrenaline or cortisol. Unfortunately, these hormones counter the effect of insulin — sometimes triggering an episode of diabetic ketoacidosis. Pneumonia and urinary tract infections are common culprits.
- A problem with insulin therapy. Missed insulin treatments or inadequate insulin therapy or a malfunctioning insulin pump can leave you with too little insulin in your system, triggering diabetic ketoacidosis.
Other possible triggers of diabetic ketoacidosis include:
- Physical or emotional trauma
- Heart attack or stroke
- Alcohol or drug abuse, particularly cocaine
- Certain medications, such as corticosteroids and some diuretics
What are the treatments for diabetic ketoacidosis (dka)?
If you're diagnosed with diabetic ketoacidosis, you might be treated in the emergency room or admitted to the hospital. Treatment usually involves:
- Fluid replacement. You'll receive fluids — either by mouth or through a vein — until you're rehydrated. The fluids will replace those you've lost through excessive urination, as well as help dilute the excess sugar in your blood.
- Electrolyte replacement. Electrolytes are minerals in your blood that carry an electric charge, such as sodium, potassium and chloride. The absence of insulin can lower the level of several electrolytes in your blood. You'll receive electrolytes through a vein to help keep your heart, muscles and nerve cells functioning normally.
- Insulin therapy. Insulin reverses the processes that cause diabetic ketoacidosis. In addition to fluids and electrolytes, you'll receive insulin therapy — usually through a vein. When your blood sugar level falls to about 200 mg/dL (11.1 mmol/L) and your blood is no longer acidic, you may be able to stop intravenous insulin therapy and resume your normal subcutaneous insulin therapy.
As your body chemistry returns to normal, your doctor will consider additional testing to check for possible triggers for the diabetic ketoacidosis. Depending on circumstances, you might need additional treatment.
For example, your doctor will help you create a diabetes treatment plan. If a bacterial infection is found, he or she might prescribe antibiotics. If a heart attack seems possible, your doctor might recommend further evaluation of your heart.
What are the risk factors for diabetic ketoacidosis (dka)?
The risk of diabetic ketoacidosis is highest if you:
- Have type 1 diabetes
- Frequently miss insulin doses
Uncommonly, diabetic ketoacidosis can occur if you have type 2 diabetes. In some cases, diabetic ketoacidosis may be the first sign that you have diabetes.
Is there a cure/medications for diabetic ketoacidosis (dka)?
Diabetic ketoacidosis (DKA) is a very serious diabetic complication where the body starts to produce high levels of blood acid - ketones. This is a condition where your body is not able to produce enough insulin naturally by the body.
The treatments which are currently prescribed for KDA are-
- Fluid Replacement: Depending on your situation, you will receive fluids to help you rehydrate. This is done to replenish the fluids lost through excessive urination while also helping dilute the excess sugar in your blood.
- Electrolyte Replacement Therapy: As you may already be aware, electrolytes are minerals found in your blood, like sodium, potassium, and chloride. In the absence of insulin, the level of the electrolytes tends to go down, and in order to replenish these lost electrolytes, doctors may inject electrolytes directly into your veins. This is done to keep your bodily functions running as smoothly as possible.
- Insulin Therapy: With fluids and electrolytes, doctors may suggest insulin therapy also to reverse the effects of diabetic ketoacidosis. In case your blood sugar levels go below 200mg/dL, your blood is longer acidic in nature. This is when you stop the intravenous insulin therapy and get back on track with the normal subcutaneous insulin therapy.
Excessive thirst,Frequent urination,Nausea and vomiting,Stomach pain,Weakness or fatigue,Shortness of breath,Fruity-scented breath,Confusion
Physical or emotional trauma,Heart attack or stroke,Pancreatitis,Alcohol or drug abuse, particularly cocaine,Certain medications, such as corticosteroids and some diuretics
Rapid-acting insulins (eg, insulin aspart, insulin glulisine, insulin lispro),Short-acting insulins (eg, regular insulin),Electrolyte supplements (eg, potassium chloride),Alkalinizing agents (eg, sodium bicarbonate)