Ketoacidosis is a dangerous and potentially fatal condition for people with diabetes that is caused by an acute, severe, and uncontrolled diabetic episode. DKA occurs when the body, lacking sufficient insulin to break down glucose for energy, turns instead to fat. The breakdown of fat for fuel releases an acid byproduct called ketones. In high levels, ketones are toxic.
DKA is more common in people with type 1 than type 2 diabetes, as people with type 2 diabetes usually produce enough insulin to prevent ketone buildup from reaching harmful levels. DKA can be the first sign of previously undiagnosed type 1 diabetes. One in four children presents with DKA at the time of type 1 diagnosis. Symptoms of DKA include excessive thirst, abdominal pain, shortness of breath, confusion, nausea/vomiting, and weight loss.
The most common complications of an episode of DKA and its subsequent treatment are cerebral edema (the leakage of fluid into the brain), hypoglycemia, and hypokalemia (low blood potassium levels). Other potential complications include acute respiratory distress syndrome and renal failure. If left untreated, DKA can result in death.
However, with proper treatment — hospitalization is usually required — DKA related mortality rates are low. Treatment goals include replacing lost fluids, using fast-acting insulin to regain control of blood sugar levels, restoring the body's electrolyte balance, and avoiding further complications.
People with diabetes can avoid ketoacidosis by monitoring their blood sugar and being aware of the warning signs of DKA. Ketone levels can be monitored with urine tests. Talk to your healthcare team if you have concerns.
PubMed Health. Diabetic Ketoacidosis. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001363/. (Accessed 2/12).
Reviewed by Joy Pape, RN, BSN, CDE, WOCN, CFNC 9/12.
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