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Encyclopedia > Diabetic ketoacidosis

Diabetic ketoacidosis(DKA) is a life-threatening complication in patients with untreated diabetes mellitus (chronic high blood sugar or hyperglycemia). Near complete deficiency of insulin and elevated levels of certain stress hormones combine to cause DKA. DKA is more common among Type I diabetics, but may also occur in Type II diabetics generally when physiologically stressed, such as during an infection. Patients with new, undiagnosed Type I diabetes frequently present to hospitals with DKA. DKA can also occur in a known diabetic who fails to take prescribed insulin. DKA was a major cause of death in Type I diabetics before insulin injections were available; untreated DKA has a high mortality rate.
For the disease characterized by excretion of large amounts of very dilute urine, see diabetes insipidus. ... In medicine, a chronic disease is a disease that is long-lasting or recurrent. ... In medicine, blood sugar is a term used to refer to levels of glucose in the blood. ... Hyperglycemia or High Blood Sugar is a condition in which an excessive amount of glucose circulates in the blood plasma. ... Insulin (from Latin insula, island, as it is produced in the Islets of Langerhans in the pancreas) is an anabolic polypeptide hormone that regulates carbohydrate metabolism. ... Stress hormones such as cortisol and norepinephrine are released at periods of high stress. ... This article is about the disease that features high blood sugar. ... See diabetes mellitus for further general information on diabetes. ... Crude death rate by country Mortality rate is a measure of the number of deaths (in general, or due to a specific cause) in some population, scaled to the size of that population, per unit time. ...

Diabetes mellitus
Types of Diabetes
Diabetes mellitus type 1
Diabetes mellitus type 2
Gestational diabetes

Pre-diabetes:
Impaired fasting glycaemia
Impaired glucose tolerance For the disease characterized by excretion of large amounts of very dilute urine, see diabetes insipidus. ... Diabetes mellitus type 1 (Type 1 diabetes, Type I diabetes, T1D, IDDM) is a form of diabetes mellitus. ... See diabetes mellitus for further general information on diabetes. ... Gestational diabetes is a form of diabetes found in pregnant women. ... Impaired fasting glycaemia (IFG) is a pre-diabetic state of dysglycemia, associated with insulin resistance and increased risk cardiovascular pathology, although of lesser risk than Impaired glucose tolerance (IGT). ... Impaired Glucose Tolerance (IGT) is a pre-diabetic state of dysglycemia, that is associated with insulin resistance and increased risk of cardiovascular pathology. ...

Disease Management
Diabetes management:
Diabetic diet
•Anti-diabetic drugs
Conventional insulinotherapy
Intensive insulinotherapy
Other Concerns
Cardiovascular disease

Diabetic comas:
Diabetic hypoglycemia
Diabetic ketoacidosis
Nonketotic hyperosmolar This article is about the management of diabetes mellitus. ... The diet recommended for people who suffer from diabetes mellitus is one that is high in dietary fibre, especially soluble fibre, but low in fat (especially saturated fat) and sugar. ... An anti-diabetic drug or oral hypoglycemic agent is used to treat diabetes mellitus. ... Conventional insulinotherapy is a therapeutic regimen for diabetes mellitus treatment. ... Intensive insulinotherapy or flexible insulin therapy is a therapeutic regimen for diabetes mellitus treatment. ... Cardiovascular disease refers to the class of diseases that involve the heart and/or blood vessels (arteries and veins). ... Diabetic coma is a medical emergency in which a person with diabetes mellitus is comatose (unconscious) because of one of three acute complications of diabetes: Severe diabetic hypoglycemia Advanced diabetic ketoacidosis advanced enough to result in unconsciousness from a combination of severe hyperglycemia, dehydration and shock, and exhaustion Hyperosmolar nonketotic... Diabetic hypoglycemia describes low blood glucose (hypoglycemia) occurring in a person with diabetes mellitus. ... Nonketotic hyperosmolar coma is a type of diabetic coma associated with a high mortality seen in diabetes mellitus type 2. ...


Diabetic myonecrosis
Diabetic nephropathy
Diabetic neuropathy
Diabetic retinopathy Please wikify (format) this article or section as suggested in the Guide to layout and the Manual of Style. ... Photomicrography of nodular glomerulosclerosis in Kimmelstein-Wilson syndrome. ... Diabetic neuropathies are neuropathic disorders that are associated with diabetes mellitus. ... Diabetic retinopathy is retinopathy (damage to the retina) caused by complications of diabetes mellitus, which could eventually lead to blindness. ...


Diabetes and pregnancy For women with diabetes mellitus, pregnancy can present some particular challenges for both mother and child. ...

Blood tests
Blood sugar
Fructosamine
Glucose tolerance test
Glycosylated hemoglobin

Contents

In medicine, blood sugar is a term used to refer to levels of glucose in the blood. ... Fructosamine, also known as Glycated Serum Protein (GSP) or Glycated Albumin, is used primarily to identify the plasma glucose concentration over time and so assess diabetic control . ... A glucose tolerance test in medical practice is the administration of glucose to determine how quickly it is cleared from the blood. ... Glycosylated (or glycated) hemoglobin (hemoglobin A1c, Hb1c , HbA1c or HgA1c) is a form of hemoglobin used primarily to identify the plasma glucose concentration over time. ...

Mechanism

DKA is characterized by hyperglycemia, acidosis, and high levels of circulating ketone bodies. The pathogenesis of DKA is mainly due to acidosis. Excessive production of ketone bodies lowers the pH of the blood; a blood pH below 6.7 is incompatible with life. Onset of DKA may be fairly rapid, often within 24 hours. Hyperglycemia or High Blood Sugar is a condition in which an excessive amount of glucose circulates in the blood plasma. ... Acidosis is an increased acidity (i. ... Ketone bodies are three chemicals that are produced as by-products when fatty acids are broken down for energy. ... Pathogenesis is the mechanism by which a certain etiological factor causes disease (pathos = disease, genesis = development). ... The correct title of this article is . ...


A key component of DKA is that there is no or very little circulating insulin so it occurs mainly (but not exclusively) in type 1 diabetes (because type 1 diabetes is characterized by a lack of insulin production in the pancreas). It is much less common in type 2 diabetes because that is closely related to cell insensitivity to insulin, not shortage or absence of insulin. Some type 2 diabetics have lost their own insulin production and must take external insulin; they have some susceptibility to DKA. Insulin (from Latin insula, island, as it is produced in the Islets of Langerhans in the pancreas) is an anabolic polypeptide hormone that regulates carbohydrate metabolism. ...


Although glucagon plays a role as an antagonistic hormone to insulin when there are low blood glucose levels, mainly by stimulating the process of glycogenolysis in hepatocytes (liver cells), insulin is the much more important hormone with more widespread effects throughout the body. Its presence or absence can by itself regulate most of DKA's pathological effects; notably, it has a short half-life in the blood of only a few minutes (typically about six), so little time is needed between cessation of insulin release internally and the reduction of insulin levels in the blood. Glucagon ball and stick model A microscopic image stained for glucagon. ... In medicine, blood sugar is glucose in the blood. ... Glycogen Glucose Glucose-6-phosphate Glycogenolysis is the catabolism of glycogen by removal of a glucose monomer and addition of phosphate to produce glucose-1-phosphate. ... Hepatocytes make up 60-80% of the cytoplasmic mass of the liver. ... Pathology (from Greek pathos, feeling, pain, suffering; and logos, study of; see also -ology) is the study of the processes underlying disease and other forms of illness, harmful abnormality, or dysfunction. ... Half-Life For a quantity subject to exponential decay, the half-life is the time required for the quantity to fall to half of its initial value. ...


Most cells in the body are sensitive to one or more of insulin's effects; the main exception being erythrocytes, neurons, hepatocytes, some intestinal tissue, and pancreatic beta-cells which do not require insulin to absorb glucose from the blood. The difference is due to different glucose transporter (GLUT) proteins. Most cells contain only GLUT-4 proteins which move to the cell surface membrane when stimulated by a second messenger cascade initiated by insulin, thus enabling uptake of glucose. Conversely, when insulin concentrations are low, these transporters dissociate from the cell membrane and so prevent uptake of glucose. Human red blood cells Red blood cells are the most common type of blood cell and are the vertebrate bodys principal means of delivering oxygen to body tissues via the blood. ... Drawing by Santiago Ramón y Cajal of neurons in the pigeon cerebellum. ... In anatomy, the intestine is the segment of the alimentary canal extending from the stomach to the anus and, in humans and other mammals, consists of two segments, the small intestine and the large intestine (or colon). ... Beta cells are a type of cell in the pancreas in areas called the islets of Langerhans. ... To meet Wikipedias quality standards, this article or section may require cleanup. ... GLUT4 is the insulin-regulated glucose transporter found in adipose tissues and striated muscle (skeletal and cardiac) that is responsible for insulin-regulated glucose disposal. ...


Other effects of insulin include stimulation of the formation of glycogen from glucose and inhibition of glycogenolysis; stimulation of fatty acid (FA) production from stored lipids and inhibition of FA release into the blood; stimulation of FA uptake and storage; inhibition of protein catabolism and of gluconeogenesis, in which glucose is synthesised (mostly from some amino acid types, released by protein catabolism). A lack of insulin therefore has significant effects, all of which contribute to increasing blood glucose levels, to increased fat metabolism and protein degradation. Fat metabolism is one of the underlying causes of DKA. This article does not cite any references or sources. ... In chemistry, especially biochemistry, a fatty acid is a carboxylic acid often with a long unbranched aliphatic tail (chain), which is either saturated or unsaturated. ... Anabolism is the aspect of metabolism that contributes to growth. ...


Muscle wasting

Muscle wasting occurs primarily due to the lack of inhibition of protein catabolism; insulin inhibits the breakdown of proteins and, since muscle tissue is protein, a lack of insulin encourages muscle wasting, releasing amino acids both to produce glucose (by gluconeogenesis) and for the synthesis of ATP via partial respiration of the remaining amino acids. It has been suggested that Muscle weakness and Dystrophy be merged into this article or section. ...


In those suffering from starvation, blood glucose concentrations are low due to both low consumption of carbohydrates and because most of the glucose available is being used as a source of energy by tissues unable to use most other sources of energy, such as neurons in the brain. Since insulin lowers blood glucose levels, the normal bodily mechanism here is to prevent insulin secretion, thus leading to similar fat and protein catabolic effects as in type 1 diabetes. Thus the muscle wastage visible in those suffering from starvation also occurs in type 1 diabetics, normally resulting in weight loss.


Ketone body production

Despite possibly high circulating levels of plasma glucose, the liver will act as though the body is starving if insulin levels are low. In starvation situations, the liver produces another form of fuel: ketone bodies. Ketogenesis, that is fat metabolic processing (beginning with lipolysis), makes ketone bodies as intermediate products in the metabolic sequence as fatty acids (formerly attached to a glycerol backbone in triglycerides) are processed. The ketone bodies beta-hydroxybutyrate and acetoacetate enter the bloodstream and are usable as fuel for some organs such as the brain, though the brain still requires a substantial proportion of glucose to function. If large quantities of ketone bodies are produced, the metabolic imbalance known as ketosis may develop, though this condition is not necessarily harmful. The positive charge of ketone bodies causes decreased blood pH. An extreme excess of ketones can cause ketoacidosis. A female child during the Nigerian-Biafran war of the late 1960s, shown suffering the effects of severe hunger and malnutrition. ... Ketone bodies are three chemicals that are produced as by-products when fatty acids are broken down for energy. ... Ketogenesis is the process by which ketone bodies are produced as a result of fatty acid breakdown. ... Fats consist of a wide group of compounds that are generally soluble in organic solvents and largely insoluble in water. ... Lipolysis is the breakdown of fat stored in fat cells. ... Beta-hydroxybutyrate, acetoacetate, and acetone collectively are called ketone bodies. ... Acetoacetic acid (also known as 3-oxobutanoic acid or diacetic acid) is a beta-keto acid of the keto acid group, its empirical formula is C4H6O3 or CH3COCH2COOH. It is a strong organic acid and can be produced in the human liver under certain conditions of poor metabolism leading to... Ketosis (IPA pronunciation: ) is a stage in metabolism occurring when the liver converts fat into fatty acids and ketone bodies which can be used by the body for energy. ...


In starvation conditions, the liver also uses the glycerol produced from triglyceride metabolism to make glucose for the brain, but there is not nearly enough glycerol to meet the body's glucose needs. Glycerol is a chemical compound with the formula HOCH2CH(OH)CH2OH. This colorless, odorless, viscous liquid is widely used in pharmaceutical formulations. ...


Brain

Normally, ketone bodies are produced in minuscule quantities, feeding only part of the energy needs of the heart and brain. In DKA, the body enters a starving state. Eventually, neurons (and so the brain) switches from using glucose as a primary fuel source to using ketone bodies. The heart and lungs, from an older edition of Grays Anatomy. ...


As a result, the bloodstream is filled with an increasing amount of glucose that it cannot use (as the liver continues gluconeogenesis and exporting the glucose so made). This significantly increases its osmolality. At the same time, massive amounts of ketone bodies are produced, which, in addition to increasing the osmolar load of the blood, are acidic. As a result, the pH of the blood begins to move downward towards an acidotic state. The normal pH of human blood is 7.35-7.45, in acidosis the pH dips below 7.35. Very severe acidosis may be as low as 6.9-7.1. The acidic shift in the blood is significant because the proteins (i.e. body tissues, enzymes, etc.) in the body will be permanently denatured by a pH that is either too high or too low, thereby leading to widespread tissue damage, organ failure, and eventually death. Pyruvic acid Oxaloacetic acid Phosphoenolpyruvate Fructose 1,6-bisphosphate Fructose 6-phosphate Glucose-6-phosphate Glucose Gluconeogenesis is the generation of glucose from non-sugar carbon substrates like pyruvate, lactate, glycerol, and amino acids (primarily alanine and glutamine). ... When substances are dissolved, the number of distinct particles in solution is measured as Osmolality. ... In chemistry, the osmole (Osm) is a non-SI unit of measurement that defines the number of moles of a chemical compound that contribute to a solutions osmotic pressure. ... Acidity redirects here. ... The correct title of this article is . ...


Glucose begins to spill into the urine as the proteins responsible for reclaiming it from urine (the SGLT family) reach maximum capacity. As glucose is excreted in the urine, it takes a great deal of body water with it, resulting in dehydration. Dehydration further concentrates the blood and worsens the increased osmolality of the blood. Severe dehydration forces water out of cells and into the bloodstream to keep vital organs perfused. This shift of intracellular water into the bloodstream occurs at a cost as the cells themselves need the water to complete chemical reactions that allow the cells to function. This article or section is in need of attention from an expert on the subject. ... In biology, an organ is a group of tissues which perform some function. ...


Symptoms and Signs

  • Sluggish, extreme tiredness.
  • Fruity smell to breath/compare to nail polish remover.
  • Extreme thirst, despite large fluid intake.
  • Constant urination
  • Extreme weight-loss.
  • Oral Thrush may be present, or/ yeast infections that fail to go away, this is because the normal fungal/flora present in oral cavity/cervix in women, the balance is upset and bacterial began to feast on the high sugar from urine output/ dry mouth from extreme thirst.
  • Muscle wasting.
  • Agitation / Irritation / Aggession / Confusion

Late signs

At this point, DKA is life-threatening and medical attention should be sought immediately.

  • Emesis (vomiting), although this is not always a sign of late-stage ketoacidosis, and can occur both in early-stage ketoacidosis and in non-ketoacidic hyperglycaemia.
  • Confusion.
  • Abdominal pain.
  • Loss of appetite.
  • Flu-like symptoms.
  • Lethargy and apathy.
  • Extreme weakness.
  • Kussmaul breathing ("air hunger"). Patients breathe more deeply and/or rapidly.
  • Unconsciousness (diabetic coma) after prolonged DKA. At this stage, speedy medical attention is imperative.

Vomiting (also throwing up or emesis) is the forceful expulsion of the contents of ones stomach through the mouth and sometimes the nose. ... Influenza, commonly known as flu, is an infectious disease of birds and mammals caused by an RNA virus of the family Orthomyxoviridae (the influenza viruses). ... Fatigue is a feeling of excessive tiredness or lethargy, with a desire to rest, perhaps to sleep. ... This article does not cite any references or sources. ... Kussmaul breathing is the rapid, deep, and labored breathing of people who have acidosis. ... Diabetic coma is a medical emergency in which a person with diabetes mellitus is comatose (unconscious) because of one of three acute complications of diabetes: Severe diabetic hypoglycemia Advanced diabetic ketoacidosis advanced enough to result in unconsciousness from a combination of severe hyperglycemia, dehydration and shock, and exhaustion Hyperosmolar nonketotic...

Complications

People with diabetic ketoacidosis need close and frequent monitoring for complications. Surprisingly, the most common complications of DKA are related to the treatment:

  • Hypokalemia
  • Cerebral edema [1]
  • Hyperglycemia
  • Ketoacidemia
  • Fluid and Electrolyte Depletion [2]
  • Aspiration
  • Unrecognize renal tubular necrosis
  • Pulmonary edema [3]

Treatment

Treatment consists of hydration to lower the osmolality of the blood, replacement of lost electrolytes, insulin to force glucose and potassium into the cells, and eventually glucose simultaneously with insulin in order to correct other metabolic abnormalities, such as elevated blood potassium (hyperkalemia) and elevated ketone levels. Many patients require admission to a step-down unit or an intensive care unit (ICU) so that vital signs, urine output, and blood tests can be monitored frequently. Brain edema is not rare, and so this may suggest intensive monitoring as well. In patients with severe alteration of mental status, intubation and mechanical ventilation may be required. Survival is dependent on how badly-deranged the metabolism is at presentation to a hospital, but the process is only occasionally fatal. In chemistry, hydration is the condition of being combined with water. ... When substances are dissolved, the number of distinct particles in solution is measured as Osmolality. ... An electrolyte is a substance containing free ions that behaves as an electrically conductive medium. ... General Name, Symbol, Number potassium, K, 19 Chemical series alkali metals Group, Period, Block 1, 4, s Appearance silvery white Standard atomic weight 39. ... Santorio Santorio (1561-1636) in his steelyard balance, from Ars de statica medecina, first published 1614 Metabolism (from μεταβολισμος(metavallo), the Greek word for change), in the most general sense, is the ingestion and breakdown of complex compounds, coupled... Hyperkalemia is an elevated blood level (above 5. ... An intensive care unit An Intensive Care Unit (ICU) or Critical Care Unit (CCU) is a specialised facility in a hospital that provides intensive care medicine. ... Vital signs are often taken by health professionals in order to assess the most basic body functions. ... This page is about the condition called edema. ... This article or section needs copy editing for grammar, style, cohesion, tone and/or spelling. ... mechanical or forced ventilation is the use of powered equipment, e. ... For the record label, see Hospital Records. ...


DKA occurs more commonly in type 1 diabetes because insulin deficiency is most severe, though it can occur in type 2 diabetes. In about a quarter of young people who develop type 1 diabetes, insulin deficiency and hyperglycemia lead to ketoacidosis before the disease is recognized and treated. This can occur at the onset of type 2 diabetes as well, especially in young people. In a person known to have diabetes and being adequately treated, DKA usually results from omission of insulin, mismanagement of acute gastroenteritis, the flu, or the development of a serious new health problem (e.g., bacterial infection, myocardial infarction). Insulin (from Latin insula, island, as it is produced in the Islets of Langerhans in the pancreas) is an anabolic polypeptide hormone that regulates carbohydrate metabolism. ... Gastroenteritis involves diarrhea or vomiting, with noninflammatory infection of the upper small bowel, or inflammatory infection of the colon, both part of the gastrointestinal tract. ... Infection is also the title of an episode of the television series Babylon 5; see Infection (Babylon 5). ... Acute myocardial infarction (AMI or MI), more commonly known as a heart attack, is a disease state that occurs when the blood supply to a part of the heart is interrupted. ...


Insulin deficiency switches many aspects of metabolic balance in a catabolic direction. The liver becomes a net producer of glucose by way of gluconeogenesis (from protein) and glycogenolysis (from glycogen, though this source is usually exhausted within hours). Fat in adipose tissue is reduced to triglycerides and fatty acids by lipolysis. Muscle is degraded to release amino acids for gluconeogenesis. The rise of fatty acid levels is accompanied by increasing levels of ketone bodies (acetone, acetoacetate and beta-hydroxybutyrate; only one, acetone, is chemically a ketone -- the name is an historical accident). As ketosis worsens, it produces a metabolic acidosis, with anorexia, abdominal distress, and eventually vomiting. The rising level of glucose increases the volume of urine produced by the kidneys (an osmolar diuresis). The high volume of urination (polyuria) also produces increased losses of electrolytes, especially sodium, potassium, chloride, phosphate, and magnesium. Reduced fluid intake from vomiting combined with amplified urination produce dehydration. As the metabolic acidosis worsens, it induces obvious hyperventilation (termed Kussmaul respiration). Kussmaul's respirations are the body's attempt to remove carbon dioxide from the blood that would otherwise form carbonic acid and further worsen the ketoacidosis. See also arterial blood gas. Anabolism is the aspect of metabolism that contributes to growth. ... Pyruvic acid Oxaloacetic acid Phosphoenolpyruvate Fructose 1,6-bisphosphate Fructose 6-phosphate Glucose-6-phosphate Glucose Gluconeogenesis is the generation of glucose from non-sugar carbon substrates like pyruvate, lactate, glycerol, and amino acids (primarily alanine and glutamine). ... Glycogen Glucose Glucose-6-phosphate Glycogenolysis is the catabolism of glycogen by removal of a glucose monomer and addition of phosphate to produce glucose-1-phosphate. ... It has been suggested that Subcutaneous fat be merged into this article or section. ... Triglyceride (blue: fatty acid; red: glycerol backbone) Triglycerides are glycerides in which the glycerol is esterified with three fatty acids. ... Lipolysis is the breakdown of fat stored in fat cells. ... The chemical compound acetone (also known as propanone, dimethyl ketone, 2-propanone, propan-2-one and β-ketopropane) is the simplest representative of the ketones. ... Acetoacetic acid (also known as 3-oxobutanoic acid or diacetic acid) is a beta-keto acid of the keto acid group, its empirical formula is C4H6O3 or CH3COCH2COOH. It is a strong organic acid and can be produced in the human liver under certain conditions of poor metabolism leading to... Beta-hydroxybutyrate, acetoacetate, and acetone collectively are called ketone bodies. ... In medicine, metabolic acidosis is a state in which the blood pH is low (under 7. ... Anorexia can refer to: Anorexia nervosa, an eating disorder in which people do not eat correctly due to the obsessive fear of weight gain Anorexia (symptom), the general symptom of decreased appetite Sexual anorexia, a term used to describe a lack of appetite for sex. ... Diuresis is the production of urine by the kidney. ... Polyuria is the passage of a large volume of urine in a given period. ... Electrolyte disturbance refers to an abnormal change in the levels of electrolytes in the body. ... General Name, Symbol, Number sodium, Na, 11 Chemical series alkali metals Group, Period, Block 1, 3, s Appearance silvery white Standard atomic weight 22. ... General Name, Symbol, Number potassium, K, 19 Chemical series alkali metals Group, Period, Block 1, 4, s Appearance silvery white Standard atomic weight 39. ... The chloride ion is formed when the element chlorine picks up one electron to form an anion (negatively-charged ion) Cl−. The salts of hydrochloric acid HCl contain chloride ions and can also be called chlorides. ... Above is a ball-and-stick model of the inorganic hydrogenphosphate anion (HPO42−). Colour coding: P (orange); O (red); H (white). ... General Name, symbol, number magnesium, Mg, 12 Chemical series alkaline earth metals Group, period, block 2, 3, s Appearance silvery white solid at room temp Standard atomic weight 24. ... Vomiting (also throwing up or emesis) is the forceful expulsion of the contents of ones stomach through the mouth and sometimes the nose. ... In medicine, metabolic acidosis is a state in which the blood pH is low (under 7. ... In medicine, hyperventilation (or hyperpnea) is the state of breathing faster or deeper (hyper) than necessary, and thereby reducing the carbon dioxide concentration of the blood below normal. ... Kussmaul breathing is the rapid, deep, and labored breathing of people who have acidosis. ... Carbonic acid (ancient name acid of air or aerial acid) has the formula H2CO3. ... Arterial blood gas measurement is a blood test that is performed to determine the concentration of oxygen, carbon dioxide and bicarbonate, as well as the pH, in the blood. ...


On presentation to hospital, patients in DKA are typically suffering dehydration and breathing both fast and deeply. Abdominal pain is common and may be severe. Consciousness level is typically normal until late in the process, when obtundation (dulled or reduced level of alertness or consciousness) may progress to coma. Dehydration can become severe enough to cause shock. Laboratory tests typically show hyperglycemia, metabolic acidosis, normal or elevated potassium, and severe ketosis. Many other tests can be affected. Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. ... Obtunded refers to a patient that has less than full mental capacity, typically as a result of a medical condition or trauma. ... In medicine, a coma (from the Greek koma, meaning deep sleep) is a profound state of unconsciousness. ... Hyperglycemia or High Blood Sugar is a condition in which an excessive amount of glucose circulates in the blood plasma. ... In medicine, metabolic acidosis is a state in which the blood pH is low (under 7. ... Hyperkalemia (hyper is high, kalium is the Latin name for potassium) is an elevated blood level (above 5. ... Ketosis (IPA pronunciation: ) is a stage in metabolism occurring when the liver converts fat into fatty acids and ketone bodies which can be used by the body for energy. ...


At this point the patient is urgently in need of intravenous fluids. The basic principles of DKA treatment are: An intravenous drip in a hospital Intravenous therapy or IV therapy is the administration of liquid substances directly into a vein. ...

  • Rapid restoration of adequate circulation and perfusion with isotonic intravenous fluids
  • Gradual rehydration and restoration of depleted electrolytes (especially sodium and potassium), even if serum levels appear adequate
  • Insulin to reverse ketosis and lower glucose levels
  • Careful monitoring to detect and treat complications

Treatment usually results in full recovery, though death can result from inadequate treatment or a variety of complications, such as cerebral edema (occurs mainly in children). This article or section does not adequately cite its references or sources. ...


  Results from FactBites:
 
Diabetic ketoacidosis - Wikipedia, the free encyclopedia (1161 words)
Diabetic ketoacidosis (DKA) is one consequence of severe, out-of-control diabetes mellitus (chronic high blood sugar, or hyperglycemia), and is linked to an impaired glucose cycle via a complex chain of events.
In a diabetes sufferer, DKA begins with relative deficiency in insulin.
When a person is known to have diabetes and is being adequately treated, DKA usually results from omission of insulin, mismanagement of acute gastroenteritis, the flu, or an overwhelming new health problem (e.g., bacterial infection, myocardial infarction).
Ketoacidosis - Wikipedia, the free encyclopedia (587 words)
Ketoacidosis is a type of metabolic acidosis which is caused by high concentrations of keto acids, formed by the deamination of amino acids.
Ketoacidosis should not be confused with ketosis, which is one of the body's normal processes for the metabolism of body fat.
The ultimate reason for ketoacidosis in both cases is the same: the cell does not have enough glucose (in the case of diabetes because lack of insulin prevents the cell from taking up glucose, in the case of starvation because there is less glucose around), so it begins metabolizing fat molecules instead of simple sugars.
  More results at FactBites »

 
 

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