Early signs DKA -
This may be caused by precipitating physiologic stress or, in some cases, maybe the initial clinical presentation in patients with previously undiagnosed diabetes. Some of the more common risk factors that can precipitate the development of extreme hyperglycemia and subsequent ketoacidosis are infection, non-adherence to insulin therapy, acute major illnesses like myocardial infarction, sepsis, pancreatitis, stress, trauma, and the use of certain medications, such as glucocorticoids or atypical antipsychotic agents which have the potential to affect carbohydrate metabolism.
AKA occurs in patients with chronic alcohol abuse. Patients can have a long-standing history of alcohol use and may also present following binges. Acetic acid is a product of the metabolism of alcohol and also a substrate for ketogenesis.
The conversion to acetyl CoA and subsequent entry into various pathways or cycles, one of which is the ketogenesis pathway is determined by the availability of insulin in proportion to the counter-regulatory hormones, which are discussed in more detail below. Under normal conditions, cells rely on free blood glucose as the primary energy source, which is regulated with insulin, glucagon, and somatostatin.
As the name implies, starvation ketoacidosis is a bodily response to prolonged fasting hypoglycemia, which decreases insulin secretion, shunting the biochemistry towards lipolysis and the oxidation of the by-product fatty acids to ensure a fuel source for the body.
According to the morbidity and mortality review of the CDC, diabetes itself is one of the most common chronic conditions in the world and affects an estimated 30 million people in the United States. Age-adjusted DKA hospitalization rates were on the downward trend in the s but have steadily been increasing from thereafter till the mids at an average annual rate of 6.
For AKA, the prevalence correlates with the incidence of alcohol abuse without racial or gender differences in incidence. It can occur at any age and mainly in chronic alcoholics but rarely in binge drinkers.
For starvation ketosis, mild ketosis generally develops after a to hour fast. It can be seen in cachexia due to underlying malignancy, patients with postoperative or post-radiation dysphagia, and prolonged poor oral intake. Ketone bodies are fat-derived fuels used by tissues at the time of limited glucose availability.
Hepatic generation of ketone bodies is usually stimulated by the combination of low insulin levels and high counter-regulatory hormone levels, including glucagon.
Low insulin levels are seen inherently in as either an absolute or relative deficiency in type I diabetes or a relative deficiency with insulin resistance in type 2 diabetes. In alcoholic or starvation conditions, low insulin levels are secondary to absolute or relative hypoglycemia.
This unfavorable ratio of insulin to glucagon activates hormone-sensitive lipase, which breaks down triglycerides in peripheral fat stores, releasing long-chain fatty acids and glycerol. The fatty acids undergo beta-oxidation in the hepatic mitochondria and generate acetyl-CoA.
With the generation of large quantities of acetyl-CoA in the more severe forms of each of these conditions, the oxidative capacity of the Krebs cycle gets saturated, and there is a spillover entry of acetyl-CoA into the ketogenic pathway and subsequent generation of ketone bodies.
An increased anion gap metabolic acidosis occurs when these ketone bodies are present as they are unmeasured anions. Alcoholic ketoacidosis [5] occurs in patients with chronic alcohol abuse and liver disease and usually develops following abrupt withdrawal of alcohol or an episode of acute intoxication.
It is not uncommon for the ingested ethanol to have already been metabolized, leading to low or normal serum levels when checked. In addition to this, the increased NADH further suppresses gluconeogenesis and reduces free glucose, perpetuating ketogenesis.
This usually happens after 2 or 3 days of fasting. After several days of fasting, protein catabolism starts, and muscles are broken down, releasing amino acids and lactate into the bloodstream, which can be converted into glucose by the liver. This biochemical process is responsible for the wasting and cachexia seen during starvation.
Patients with DKA may have a myriad of symptoms on presentation, usually within several hours of the inciting event. Symptoms of hyperglycemia are common, including polyuria, polydipsia, and sometimes more severe presentations include unintentional weight loss, vomiting, weakness, and mentation changes.
Dehydration and metabolic abnormalities worsen with progressive uncontrolled osmolar stress, which can lead to lethargy, obtundation, and may even cause respiratory failure, coma, and death. Abdominal pain is also a common complaint in DKA. Patients with AKA usually present with abdominal pain and vomiting after abruptly stopping alcohol.
On physical exam, most of the patients with ketoacidoses present with features of hypovolemia from gastrointestinal or renal fluid and electrolyte losses. In severe cases, patients may be hypotensive and in frank shock. They may have a rapid and deep respiratory effort as a compensatory mechanism, known as Kussmaul breathing.
They may have a distinct fruity odor to their breath, mainly because of acetone production. There may be neurological deficits in DKA, but less often in AKA. AKA patients may have signs of withdrawal like hypertension and tachycardia. There are signs of muscle wasting in patients with starvation ketoacidosis like poor muscle mass, minimal body fat, obvious bony prominences, temporal wasting, tooth decay, sparse, thin, dry hair and low blood pressure, pulse, and temperature.
The initial laboratory evaluation of a patient with suspected DKA includes blood levels of glucose, ketones, blood urea nitrogen, creatinine, electrolytes, calculated anion gap, arterial blood gases, osmolality, complete blood count with differential, blood cultures and urine studies including ketones, urinalysis, urine culture, chest radiograph, and an electrocardiogram.
Hyperglycemia is the typical finding at presentation with DKA, but patients can present with a range of plasma glucose values. Although ketone levels are generally elevated in DKA, a negative measurement initially does not exclude the diagnosis because ketone laboratory measurements often use the nitroprusside reaction, which only estimates acetoacetate and acetone levels that may not be elevated initially as beta-hydroxybutyrate is the major ketone that is elevated.
The anion-gap is elevated, as mentioned above, because ketones are unmeasured anions. Leukocytosis may indicate an infectious pathology as the trigger and cultures are sent from blood, urine, or other samples as clinically indicated.
Serum sodium is usually relatively low because of shifts of solvent water from the intracellular to extracellular spaces because of the osmotic pull of hyperglycemia. Hence, normal or elevated serum sodium is indicative of severe volume depletion.
Serum potassium levels may be elevated due to shifts from the intracellular compartment for exchange with acids in the absence of insulin and normal or low potassium, indicating an overall depleted body store and subsequent need for correction before initiation of insulin therapy.
In AKA, transaminitis, and hyperbilirubinemia due to concurrent alcoholic hepatitis may also be present. The alcohol level itself need not be elevated as the more severe ketoacidosis is seen once the level falls, and the counter-regulatory response begins and shunts the metabolism towards lipolysis.
Hypokalemia and increased anion-gap are usually seen with similar mechanisms to those seen in DKA. Hypomagnesemia and hypophosphatemia are common problems seen in the laboratory evaluation due to decreased dietary intake and increased losses.
As mentioned above, the direct measurement of serum beta-hydroxybutyrate is more sensitive and specific than the measurement of urine ketones. Starvation ketoacidoses patients may again have multiple electrolyte abnormalities due to chronic malnutrition, along with vitamin deficiencies.
The pH may not be as low as in DKA or AKA, and the glucose levels may be relatively normal. After the initial stabilization of circulation, airway, and breathing as a priority, specific treatment of DKA requires correction of hyperglycemia with intravenous insulin, frequent monitoring, and replacement of electrolytes, mainly potassium, correction of hypovolemia with intravenous fluids, and correction of acidosis.
Given the potential severity and the need for frequent monitoring for intravenous insulin therapy and possible arrhythmias, patients may be admitted to the intensive care unit. Blood glucose levels and electrolytes should be monitored on an hourly basis during the initial phase of management.
Aggressive volume resuscitation with isotonic saline infusion is recommended in the initial management of DKA. Volume expansion not only corrects the hemodynamic instability but also improves insulin sensitivity and reduces counter-regulatory hormone levels.
After starting with isotonic saline, the subsequent options can be decided on the serum sodium levels that are corrected for the level of hyperglycemia. Normal or high serum sodium levels warrant replacement with hypotonic saline, and low sodium levels warrant continuation of the isotonic saline.
Like mentioned above, potassium levels are usually high because of the transcellular shifts due to the acidosis and the lack of insulin. When the potassium levels are low, this means that the total body potassium is low, and hence, insulin therapy should be postponed till at least the level of serum potassium is greater than 3.
Otherwise, a further drop in levels would put the patient at risk for cardiac arrhythmias. In the 3. The treatment of the acidosis itself is more controversial. Treatment with sodium bicarbonate therapy is controversial. It has been studied and found to provide no added benefit when the arterial blood pH is greater than 6.
Several studies have found higher potassium requirements in patients receiving bicarbonate. Studies in children have observed a possible association between bicarbonate therapy and cerebral edema. AKA typically responds to treatment with intravenous saline and intravenous glucose, with rapid clearance of the associated ketones due to a reduction in counter-regulatory hormones and the induction of endogenous insulin.
Thiamine replacement is important in alcohol-related presentations, including intoxication, withdrawal, and ketoacidosis, and should be initially done parenterally and after that maintained orally.
Electrolyte replacement is critical. Potassium losses that occur through gastrointestinal GI or renal losses should be monitored and replaced closely as glucose in the replacement fluid induces endogenous insulin, which in turn drives the extracellular potassium inside the cells.
Also of paramount importance is monitoring and replacing the magnesium and phosphate levels, which are usually low in both chronic alcoholism and prolonged dietary deprivation as in starvation. The treatment of starvation ketoacidosis is similar to AKA. Patients need to be monitored for refeeding syndrome, which is associated with electrolyte abnormalities seen when aggressive feeding is started in an individual starved for a prolonged time.
The resultant insulin secreted causes significant transcellular shifts, and hence similar to AKA, monitoring and replacing potassium, phosphate, and magnesium is very important.
Hyperosmolar hyperglycemic state HHS occurs in the setting of insulin resistance and is more typical of type 2 diabetes. There is sufficient insulin in patients with HHS to suppress lipolysis and production of ketone bodies, but inadequate amounts to prevent the hyperglycemia, dehydration, and hyperosmolality, characteristic of HHS.
An illness or event that leads to dehydration will often precipitate the hyperglycemia associated with HHS. The development of HHS is less acute than DKA and may take days to weeks to develop.
HHS typically presents with more extreme hyperglycemia and mental status changes compared with DKA. HHS typically presents with normal or small amounts of urine or serum ketones. Lactic acidosis is an alternative cause of an increased anion gap metabolic acidosis. Lactic acidosis is found with tissue hypoperfusion, hematological malignancies, and various medications.
Rhabdomyolysis is a diagnostic consideration in a patient with a history of alcohol use disorder and an anion gap metabolic acidosis, but this condition is frequently associated with hyperkalemia, hyperphosphatemia, hypocalcemia, and a urinalysis positive for blood with no erythrocytes visible on urine microscopy.
Acute abdominal surgical emergencies, such as acute pancreatitis, should be considered differentials when abdominal pain is the main presentation. The American Association of Clinical Endocrinologists and the American College of Endocrinology have reviewed reported cases of DKA in patients taking SGLT2 inhibitors.
Therefore, rather than relying on the presence of hyperglycemia, close attention to signs and symptoms of DKA is needed. In May , the US Food and Drug Administration FDA issued a warning [B] that treatment with sodium-glucose transporter-2 SGLT2 inhibitors, which include canagliflozin, dapagliflozin, and empagliflozin, may increase the risk of diabetic ketoacidosis DKA in patients with diabetes mellitus.
The FDA Adverse Event Reporting System database identified 20 cases of DKA in patients treated with SGLT2 inhibitors from March to June Diabetes, once diagnosed, is mostly managed with changes in diet, lifestyle, and medication adherence. The goal is to prevent high glucose levels, which helps prevent diabetic complications.
To prevent the complications of diabetes like ketoacidosis, the condition is best managed by an interprofessional team that includes the diabetic nurse educator, dietician, nurse practitioner, pharmacist, primary care provider, and an endocrinologist; all these clinicians should educate the patient on glucose control at every opportunity.
Empowering the patient regarding management is hence of the utmost importance. Diabetes self-management education DSME and diabetes self-management support DSMS are recommended at the time of diagnosis of prediabetes or diabetes and throughout the lifetime of the patient.
DSMS is an individualized plan that provides opportunities for educational and motivational support for diabetes self-management.
DSME and DSMS jointly provide an opportunity for collaboration between the patient and health care providers to assess educational needs and abilities, develop personal treatment goals, learn self-management skills, and provide ongoing psychosocial and clinical support. The diabetic nurse should follow all outpatients to ensure medication compliance, followup with clinicians, and adopting a positive lifestyle.
Further, the nurse should teach the patient how to monitor home blood glucose and the importance of careful monitoring of blood sugars during infection, stress, or trauma. The physical therapist should be involved in educating the patient on exercise and the importance of maintaining healthy body weight.
The social worker should be involved to ensure that the patient has the support services and financial assistance to undergo treatment.
The members of the interprofessional team should communicate to ensure that the patient is receiving the optimal standard of care. Improved outcomes and reduced costs have been associated with DSME and DSMS.
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If your sugar is very high or symptoms are severe especially confusion , you should go to the nearest emergency room. The main cause of DKA is not producing enough insulin.
Your cells need sugar for energy. To get energy, your body starts to burn fat. This process causes ketones to build up. Ketones can poison the body.
DKA can be caused by missing an insulin dose, eating poorly, or feeling stressed. An infection or other illness such as pneumonia or a urinary tract infection can also lead to DKA. If you have signs of infection fever, cough, or sore throat , contact your doctor.
For some people, DKA may be the first sign they have diabetes. If you think you may have diabetic ketoacidosis, contact your doctor right away. They will want to run some blood tests before giving you an official diagnosis. These tests include checking your blood sugar and ketone level.
Your doctor also may order a urinalysis requiring a urine sample and chest X-ray. If you have diabetes, there are some things you can do to watch for diabetic ketoacidosis.
Ask your doctor what your critical blood sugar level is. Patients should watch their glucose level closely when those levels are more than mg per dL. If your blood sugar reaches a critical level, check it every 1 to 2 hours. Ask your doctor if you should test your blood sugar level during the night.
You should talk to your doctor to develop a plan if your blood sugar level gets too high. Make sure that you know how to reach your doctor in an emergency.
DKA causes excessive urination. This means you will urinate more than usual. You can become dehydrated and your body can lose electrolytes minerals in your blood that help your body function.
If you are diagnosed with DKA, your doctor will most likely treat you with fluids usually through an IV. These fluids will contain electrolytes and insulin. Electrolytes will help your body function normally.
Insulin will help lower your blood sugar level. Overall, fluids can help rehydrate you and dilute some of the sugar in your blood.
Keeping the balance between blood sugar and insulin is the key to controlling diabetic ketoacidosis. In most cases, this means sticking to your insulin schedule.
You should also try to recognize when you feel stressed or sick. Small adjustments to your eating or drinking can make a big difference. You should keep taking your insulin, even if you are too sick to eat. If you use an insulin pump, keep a variety of supplies on hand.
Make sure that you have short-acting insulin, long-acting insulin, and needles in case your pump is not working right. You also should have an emergency phone number to call for help with your pump. If your blood sugar level is more than mg per dL, avoid foods that are high in carbohydrates.
National Institutes of Health, MedlinePlus: Diabetic Ketoacidosis. This article was contributed by: familydoctor.
org editorial staff. This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Sugar is a simple carbohydrate that provides calories for your body to use as energy. There are two main…. Exercise can help people who have diabetes. It can help control your weight, lower your blood sugar level, and…. Visit The Symptom Checker.
Read More. Food Poisoning.
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Ask your doctor if you should test your blood AErly level during the Advanced medical imaging. You should talk to your doctor to develop a plan if your blood sugar level gets too high.
Make sure that you know how to reach your doctor in an emergency. DKA causes excessive urination. This means you will urinate more than usual. You can become dehydrated and your body can lose electrolytes minerals in your blood that help your body function.
If you are diagnosed with DKA, your doctor will most likely treat you with fluids usually through an IV. These fluids will contain electrolytes and insulin.
Electrolytes will help your body function normally. Insulin will help lower your blood sugar level. Overall, fluids can help rehydrate you and dilute some of the sugar in your blood. Keeping the balance between blood sugar and insulin is the key to controlling diabetic ketoacidosis.
In most cases, this means sticking to your insulin schedule. You should also try to recognize when you feel stressed or sick. Small adjustments to your eating or drinking can make a big difference.
You should keep taking your insulin, even if you are too sick to eat. If you use an insulin pump, keep a variety of supplies on hand. Make sure that you have short-acting insulin, long-acting insulin, and needles in signd your pump is not working right.
You also should have an emergency phone number to call for help with your pump. If your blood sugar level is more than mg per dL, avoid foods that are high in carbohydrates. National Institutes of Health, MedlinePlus: Diabetic Ketoacidosis. This article was contributed by: familydoctor.
org editorial staff. This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Sugar is a simple carbohydrate that provides calories for your body to use as energy. There are two main….
Exercise can help people who have diabetes. It can help control your weight, lower your blood sugar level, and…. Visit The Symptom Checker. Read More. Food Poisoning. Acute Bronchitis. Eustachian Tube Dysfunction.
Bursitis of the Hip. High Blood Pressure. RSV Respiratory Syncytial Virus. Home Diseases and Conditions Diabetic Ketoacidosis. Table of Contents. Added Sugar: What You Need To Know. Diabetes and Nutrition. Diabetes and Exercise. What is diabetic ketoacidosis? Symptoms of diabetic ketoacidosis DKA is a very serious condition.
The first symptoms to appear are usually: Excessive thirst Dry mouth Frequent urination The next stage of DKA symptoms includes: Vomiting usually more than once Abdominal pain Diarrhea Trouble breathing Confusion or trouble concentrating Loss of appetite Weakness and fatigue A fruity odor on the breath If your sugar is very high or symptoms are severe especially confusionyou should go to the nearest emergency room.
What causes diabetic ketoacidosis? High blood glucose levels can also eigns you to urinate often. This leads to dehydration. How is diabetic ketoacidosis diagnosed? Can diabetic ketoacidosis be prevented or avoided? Diabetic ketoacidosis treatment DKA causes excessive urination.
Living with diabetic ketoacidosis Keeping the balance between blood sugar and insulin is the key to controlling diabetic ketoacidosis. What else should I do?
Do I have diabetes? Am I at risk of diabetic ketoacidosis? Will diet and exercise help me to avoid diabetic ketoacidosis? Is it safe for me to exercise? What is the best way for me to check the ketone level in my body?
I missed a dose of insulin. Should I start testing my blood sugar level and ketone level right away? Last Updated: May 1, This article was contributed by: familydoctor.
org editorial staff Categories: Family HealthFood and NutritionMenPrevention and WellnessSeniorsSugar and Sugar SubstitutesWomenYour Health Resources. Tags: diabetesdiabetic ketoacidosisEndocrinologicUrination Problem. Copyright © American Academy of Family Physicians This information provides a general overview and may not apply to everyone.
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: Early signs DKA| Diabetes & DKA (Ketoacidosis) | Elsevier Health Sciences. This situation requires ICU admission, monitoring of the central venous pressure which requires the insertion of a central venous catheter in a large upper body vein , and the administration of medication that increases the heart pumping action and blood pressure. Insulin helps sugar enter the cells in the body. Research Faculty. Learn more about what ketones are and when to test your…. |
| For more tips like these on living with type 1 diabetes, sign up for JDRF emails. | Furthermore, markers of sign Early signs DKA blood countC-reactive protein and acute pancreatitis amylase and Eqrly Early signs DKA Eary measured. Effective Antispasmodic Treatments risk of diabetic ketoacidosis DDKA highest Esrly you: Have type 1 diabetes Often miss insulin doses Sometimes, diabetic ketoacidosis can occur with type 2 diabetes. The members of the interprofessional team should communicate to ensure that the patient is receiving the optimal standard of care. Español Other Languages. February When you are ill when you have a cold or the flu, for examplecheck for ketones every four to six hours. |
| Diabetic Ketoacidosis | Diabetes | CDC | The condition develops when the body can't produce enough insulin. Insulin plays a key role in helping sugar — a major source of energy for muscles and other tissues — enter cells in the body. Without enough insulin, the body begins to break down fat as fuel. This causes a buildup of acids in the bloodstream called ketones. If it's left untreated, the buildup can lead to diabetic ketoacidosis. If you have diabetes or you're at risk of diabetes, learn the warning signs of diabetic ketoacidosis and when to seek emergency care. Diabetic ketoacidosis symptoms often come on quickly, sometimes within 24 hours. For some, these symptoms may be the first sign of having diabetes. Symptoms might include:. More-certain signs of diabetic ketoacidosis — which can show up in home blood and urine test kits — include:. If you feel ill or stressed or you've had a recent illness or injury, check your blood sugar level often. You might also try a urine ketone test kit you can get at a drugstore. Sugar is a main source of energy for the cells that make up muscles and other tissues. Insulin helps sugar enter the cells in the body. Without enough insulin, the body can't use sugar to make the energy it needs. This causes the release of hormones that break down fat for the body to use as fuel. This also produces acids known as ketones. Ketones build up in the blood and eventually spill over into the urine. Sometimes, diabetic ketoacidosis can occur with type 2 diabetes. In some cases, diabetic ketoacidosis may be the first sign of having diabetes. Diabetic ketoacidosis is treated with fluids, electrolytes — such as sodium, potassium and chloride — and insulin. Perhaps surprisingly, the most common complications of diabetic ketoacidosis are related to this lifesaving treatment. Diabetes complications are scary. But don't let fear keep you from taking good care of yourself. Follow your diabetes treatment plan carefully. Ask your diabetes treatment team for help when you need it. Diabetic ketoacidosis. Diabetic ketoacidosis is a serious complication of diabetes. Symptoms might include: Being very thirsty Urinating often Feeling a need to throw up and throwing up Having stomach pain Being weak or tired Being short of breath Having fruity-scented breath Being confused More-certain signs of diabetic ketoacidosis — which can show up in home blood and urine test kits — include: High blood sugar level High ketone levels in urine. When to see a doctor. You have ketones in your urine and can't reach your health care provider for advice. You have many symptoms of diabetic ketoacidosis. These include excessive thirst, frequent urination, nausea and vomiting, stomach pain, weakness or fatigue, shortness of breath, fruity-scented breath, and confusion. Remember, untreated diabetic ketoacidosis can lead to death. Diabetic ketoacidosis usually happens after: An illness. An infection or other illness can cause the body to make higher levels of certain hormones, such as adrenaline or cortisol. These hormones work against the effects of insulin and sometimes cause diabetic ketoacidosis. Pneumonia and urinary tract infections are common illnesses that can lead to diabetic ketoacidosis. You have many symptoms of diabetic ketoacidosis. These include excessive thirst, frequent urination, nausea and vomiting, stomach pain, weakness or fatigue, shortness of breath, fruity-scented breath, and confusion. Remember, untreated diabetic ketoacidosis can lead to death. Request an appointment. From Mayo Clinic to your inbox. Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview. To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail. Diabetic ketoacidosis usually happens after: An illness. An infection or other illness can cause the body to make higher levels of certain hormones, such as adrenaline or cortisol. These hormones work against the effects of insulin and sometimes cause diabetic ketoacidosis. Pneumonia and urinary tract infections are common illnesses that can lead to diabetic ketoacidosis. A problem with insulin therapy. Missed insulin treatments can leave too little insulin in the body. Not enough insulin therapy or an insulin pump that doesn't work right also can leave too little insulin in the body. Any of these problems can lead to diabetic ketoacidosis. Other things that can lead to diabetic ketoacidosis include: Physical or emotional trauma Heart attack or stroke Pancreatitis Pregnancy Alcohol or drug misuse, particularly cocaine Certain medicines, such as corticosteroids and some diuretics. The risk of diabetic ketoacidosis is highest if you: Have type 1 diabetes Often miss insulin doses Sometimes, diabetic ketoacidosis can occur with type 2 diabetes. Possible complications of the treatments Treatment complications include: Low blood sugar, also known as hypoglycemia. Insulin allows sugar to enter cells. This causes the blood sugar level to drop. If the blood sugar level drops too quickly, the drop can lead to low blood sugar. Low potassium, also known as hypokalemia. The fluids and insulin used to treat diabetic ketoacidosis can cause the potassium level to drop too low. A low potassium level can affect the heart, muscles and nerves. To avoid this, potassium and other minerals are usually given with fluid replacement as part of the treatment of diabetic ketoacidosis. Swelling in the brain, also known as cerebral edema. Adjusting the blood sugar level too quickly can cause the brain to swell. This appears to be more common in children, especially those with newly diagnosed diabetes. Untreated, diabetic ketoacidosis can lead to loss of consciousness and, eventually, death. There are many ways to prevent diabetic ketoacidosis and other diabetes complications. Manage your diabetes. Make healthy eating and physical activity part of your daily routine. Take diabetes medicines or insulin as directed. Monitor your blood sugar level. You might need to check and record your blood sugar level at least 3 to 4 times a day, or more often if you're ill or stressed. Careful monitoring is the only way to make sure that your blood sugar level stays within your target range. Adjust your insulin dosage as needed. Talk to your health care provider or diabetes educator about how to make your insulin dosage work for you. Consider factors such as your blood sugar level, what you eat, how active you are, and whether you're ill. If your blood sugar level begins to rise, follow your diabetes treatment plan to return your blood sugar level to your target range. Check your ketone level. When you're ill or stressed, test your urine for excess ketones with a urine ketones test kit. You can buy test kits at a drugstore. If your ketone level is moderate or high, contact your health care provider right away or seek emergency care. If you have low levels of ketones, you may need to take more insulin. Be prepared to act quickly. If you think you have diabetic ketoacidosis because your blood sugar is high and you have too many ketones in your urine, seek emergency care. By Mayo Clinic Staff. Oct 06, Show References. DKA ketoacidosis and ketones. American Diabetes Association. Accessed Sept. Diabetic ketoacidosis DKA. Merck Manual Professional Version. Hirsch IB, et al. Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Clinical features, evaluation, and diagnosis. Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Treatment. Ferri FF. Diabetic ketoacidosis. In: Ferri's Clinical Advisor Elsevier; Evans K. Diabetic ketoacidosis: Update on management. |
| Diabetic Ketoacidosis | Twitter Channel Facebook Profile Pinterest Profile. Rosen's Emergency Medicine: Concepts and Clinical Practice. Relatively rapid [1]. Review Glucose and ketone body kinetics in diabetic ketoacidosis. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A. This can be administered immediately after the potassium level is known to be higher than 3. |
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