Diabetic Mellitus – Acute Complications – Diabetic Ketosis – DKA

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If you are diabetic you are at risk of developing diabetic ketoacidosis.

What is diabetic ketoacidosis?

Diabetic ketoacidosis is an acute complication of diabetes mellitus that causes unconsciousness and death if not treated promptly. DKA consist of the biochemical triad of

a}hyperglycemia.

b}Acidaemia {excessive acid levels in the blood}

c}Ketonaemia{excessive ketones in the blood}

Symptoms

-Symptoms of poor glucose control would have appeared several days before onset of metabolic alterations which are typical and symptoms appear over a short period. It includes;

-vomiting

-abdominal pain

-dehydration

-weakness

-altered level of consciousness

-fruity mouth odor{similar to the odor of nail polish and nail remover}

-hyperventilation, high breathing, known in medical terms as kaussmal’s breathing

-body temperature may be normal, increased or decreased

-convulsions

Predisposing factors

-acute illness like pneumonia, urinary tract infection, sepsis

-alcohol abuse

-stroke

-kidney failure

-intestinal obstruction

-use of certain drugs like B adrenergic blockers{eg propanolol},calcium channel blockers{eg nifedipine]

-poor drug usage leading to omission of use of insulin and antidiabetic drugs.

Treatment

DKA is a medical emergency that needs prompt medical attention ,so once the symptoms are recognized, the victim should be taken straight away to the hospital. The medical treatment will aim to:

a-improve circulatory volume and reduce dehydration by adequate re hydration with normal saline

b-quickly reduce blood sugar and blood osmolality towards normal levels with the use of intravenous insulin.

c-identifying and treating precipitating events

d-correcting electrolyte imbalance

e-clearing the blood and urine of ketones at a steady rate



Source by Bello Ade