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ketoacidosis (DKA) is a life-threatening condition that develops when cells in
the body are unable to get the sugar (glucose) they need for energy, such as
when you have
diabetes and do not get enough insulin. Without
insulin, the body cannot use sugar for energy. When the cells do not receive
sugar, the body begins to break down fat and muscle for energy. When this
ketones, or fatty acids, are produced and enter the
bloodstream, causing the chemical imbalance (metabolic acidosis) called
Ketoacidosis can be caused by not
getting enough insulin, having a severe infection or other illness, becoming
dehydrated, or some combination of these things. It
can occur in people who have little or no
insulin in their bodies (mostly people with
type 1 diabetes but it can happen with
type 2 diabetes) when their blood sugar levels are
Your blood sugar may be
quite high before you notice symptoms, which include:
When diabetic ketoacidosis is severe, you may have
a hard time breathing, your brain may swell (cerebral edema), and there is a
risk of coma and even death.
Laboratory tests, including
blood and urine tests, are used to confirm a diagnosis of
diabetic ketoacidosis. Urine dipstick tests for
ketones are available for home use. Keep some nearby in case your blood sugar
level becomes high.
ketoacidosis is severe, it must be treated in the hospital, often in an
intensive care unit. Treatment involves giving insulin and fluids through a
vein and closely watching certain chemicals in the blood (electrolytes). It can take several days for your blood
sugar level to return to a target range.
If you have type 1
diabetes, you are at risk for DKA if you do not get enough insulin, have a
severe infection or other illness, or become severely dehydrated. In some cases
DKA can be the first sign of diabetes.
The American Diabetes Association (ADA) is a national organization
for health professionals and consumers. Almost every state has a local office.
ADA sets the standards for the care of people with diabetes. Its focus is on
research for the prevention and treatment of all types of diabetes. ADA
provides patient and professional education mainly through its publications,
which include the monthly magazine Diabetes Forecast,
books, brochures, cookbooks and meal planning guides, and pamphlets. ADA also
provides information for parents about caring for a child with diabetes.
Other Works Consulted
Cooppan R, et al. (2010). Acute complications. In RS Beaser, ed., Joslin's Diabetes Deskbook: A Guide for Primary Care Providers, 2nd ed., pp. 419–443. Boston: Joslin Diabetes Center.
Eisenbarth GS, Buse JB (2011). Type 1 diabetes mellitus. In S Melmed et al., eds., Williams Textbook of Endocrinology, 12th ed., pp. 1436–1461. Philadelphia: Saunders.
Masharani U, German MS (2011). Pancreatic hormones and diabetes mellitus. In DG Gardner, D Shoback, eds., Greenspan's Basic and Clinical Endocrinology, 9th ed., pp. 573–655. New York: McGraw-Hill.
May 21, 2012
E. Gregory Thompson, MD - Internal Medicine & David C.W. Lau, MD, PhD, FRCPC - Endocrinology
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