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Diabetic Ketoacidosis


Disease: Diabetic Ketoacidosis Diabetic Ketoacidosis
Category: Endocrine and metabolic diseases

Disease Definition:

A serious complication of diabetes is called diabetic ketoacidosis, which develops when there’s too little insulin in a person’s body. Sugar (glucose) can’t enter the cells for energy without enough insulin, resulting in the body’s breaking down fat for energy. Toxic acids known as ketones results from this process. Loss of consciousness may result if diabetic ketoacidosis is left untreated, and eventually, it may be fatal.


Even though diabetic ketoacidosis can occur in people with gestational diabetes or type 2 diabetes, but it usually occurs in people with type 1 diabetes. Sometimes, the first sign that a person has diabetes may be diabetic ketoacidosis. People who have diabetic ketoacidosis or those that are at risk of this condition should know when to seek emergency care and learn the warning sign of this condition.

Work Group:

Symptoms, Causes


Within 24 hours, the symptoms of diabetic ketoacidosis may develop and include:

  • Loss of appetite
  • Confusion
  • Excessive thirst
  • Shortness of breath
  • Nausea and vomiting
  • Fruity-scented breath
  • Abdominal pain
  • Frequent urination
  • Fatigue or weakness


High ketone level in the urine and high blood sugar level are some of the more specific signs of diabetic ketoacidosis that can be detected through home urine and blood testing kits. When someone suspects that he/she has diabetic kitoacidosis, emergency care should be sought because if this condition is left untreated, it can be fatal.


The main source of energy for the cells that make up a person’s muscles are other tissues is sugar. A person’s body won’t be able to use sugar for energy in case he/she doesn’t have enough insulin. This will prompt the release of hormones that break down fat as an alternate fuel. This process will produce toxic acids called ketones. The excess ketones will accumulate in the blood and then “spill over” into the urine. some of the things that may trigger diabetic ketoacidosis include:


A problem with insulin therapy:

An episode of diabetic ketoacidosis may be triggered due to the presence of too little insulin in a person’s system as a result of missed insulin treatments or inadequate insulin therapy.


An illness:

Certain hormones such as adrenaline may be produced by the body due to an infection including urinary tract infections or pneumonia, or some other illness. These hormones may sometimes trigger an episode of diabetic ketoacidosis because they work against insulin.


Some of the other conditions that have the potential to cause diabetic ketoacidosis are:

  • Heart attack
  • Stroke
  • Stress
  • Alcohol or drug abuse
  • Surgery
  • High fever
  • Physical or emotional trauma



Fluids, electrolytes, and insulin are the basic elements in treating diabetic ketoacidosis. Ironically, the most common complications of diabetic ketoacidosis are related to this lifesaving treatment:



Insulin allows sugar to enter the cells and thus cause the blood sugar level to decrease. A person may develop hypoglycemia in case his/her blood sugar level drops too quickly.



A person’s potassium level may drop too low due to the effect of the fluids that are used in treating diabetic ketoacidosis. The activities or the muscles, nerves and heart may be impaired due to a low potassium level.


Cerebral edema:

Swelling in the brain may be the result of adjusting a person’s blood sugar level too quickly. Children, particularly those who have been recently diagnosed with diabetes, experience this complication more commonly.


A person’s risks will be much greater in case diabetic ketoacidosis is left untreated. This condition may lead to a loss of consciousness and may eventually be fatal.


A person diagnosed with diabetic ketoacidosis will probably be treated in the emergency room or be admitted to the hospital. A three-prong approach is used in treating diabetic ketoacidosis:


Fluid replacement:

Until the patient is rehydrated, he/she will receive fluids either orally or intravenously. These fluids will replace what the patient has lost through excessive urination and will help in diluting the excess sugar in his/her blood.


Electrolyte replacement:

The minerals in the blood that carry an electric charge, such as potassium, sodium and chloride, are called electrolytes. The level of several electrolytes in the blood may be lowered by the absence of insulin. To help the patient’s muscles, nerves and heart to start functioning normally, he/she will receive electrolytes intravenously.


Insulin therapy:

The processes that cause diabetic ketoacidosis are reversed by insulin. The patient will receive insulin therapy, usually intravenously, along with fluids and electrolytes. The intravenous insulin therapy may be stopped and the patient may resume his/her normal insulin therapy once the blood sugar level falls below 14 mmol/L or 250 mg/dL, and the blood is no longer acidic.


The doctor will start considering what may have triggered the episode of diabetic ketoacidosis once the patient’s body chemistry returns to normal. The patient may need additional treatment depending on his/her specific condition. For instance, the doctor will help the patient in creating a diabetes treatment plan in case the patient has undiagnosed diabetes. On the other hand, the doctor may prescribe antibiotics in case a bacterial infection is suspected. The doctor may also recommend further evaluation of the patient’s heart in case a heart attack seems possible.


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