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                Diabetic Ketoacidosis

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Diabetic Ketoacidosis (DKA)

 

 

 

Diabetic ketoacidosis, also called diabetic coma.

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A life-threatening condition that can occur in patients with diabetes mellitus.

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It is caused by failure to take insulin or anything that increases the body's need for insulin, as infection, surgery, injury, or stress.

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Warning signs include a dull headache, fatigue, extreme thirst, pain below the breastbone, nausea, dry lips, sunken eyes, and a fruity breath odor. The temperature usually rises and then falls. 

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The ketoacidosis is a medical emergency. The person should be taken to a hospital as soon as symptoms develop. 

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Immediate treatment is to give insulin and replace fluids to help dehydration.

 

Diabetic ketoacidosis is a metabolic disorder consisting of three major abnormalities:

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Elevated glucose level. (hyperglycemia).

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High ketone bodies in blood. (hyperketonemia)

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Metabolic acidosis.

 

Dehydration and hyperosmolarity are usually present.

 

Precipitating factors for Diabetic ketoacidosis (DKA).

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DKA  develops due to either an absolute or a relative absence of insulin.

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In Type 2diabetes, it is usually a relative lack of insulin, whereas in  Type 1diabetes there is an absolute absence of insulin.

 

 

Causes of Diabetic ketoacidosis

  1. Absolute lack of insulin

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Type 1 diabetes

  1. Relative lack of insulin

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Acute illness :Infection, trauma, stroke, heart attack. etc.

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Endocrine disorders.

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Drugs like steroids, beta blockers, alcohol etc.

Clinical features

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Polyuria (increased urination).

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Polydipsia (increased thirst).

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Weight loss.

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Anorexia (decreased appetite).

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Nausea and /or vomiting.

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Abdominal pain.

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Dehydration. (sunken eye balls, dry tongue, reduced tissue turgor).

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Shock.

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Hyperventilation (increased respiration-Kussmaul's breathing).

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Smell of ketone. (chemical substance formed in body in Diabetic ketoacidosis)

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Precipitating illness like infections etc.

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Confusion and later on coma (5-10%).

 

 

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