treatment,causes,Diabetic Ketoacidosis (DKA)-symptoms,

                       Diabetic Ketoacidosis

• DKA is caused by an absence or markedly inadequate amounts of insulin and has three major features of  hyperglycemia, dehydration and acidosis. 

Manifestations: 

• Dehydration  

• Tachycardia  

• Kussmaul’s respirations  

• Nausea and vomiting  

• Abdominal pain  

• Acetone breath (fruity odor)  

• Decreased level of consciousness  

DKA: 

• Blood glucose levels more than 250 mg/dL.  

• Ketoacidosis is reflected in low serum bicarbonate and low pH values.  

• High level of ketone bodies in blood and urine.  

• Sodium and potassium concentrations may vary depending on the degree of dehydration.  

• Increased levels of creatinine, blood urea nitrogen, and hematocrit.  

• Arterial blood gas indicate metabolic acidosis.  

Management of DKA: 

• Treatment goal is to supply sufficient doses of insulin, prevent dehydration, and acidosis. 

• Normal saline (0.9%) is infused at a high rate to replace fluid loss.  

• Administer regular insulin infusion at a rate of 0.1 ml/kg/hour.  

• Monitor serum glucose levels as insulin is administered.  

• Monitor potassium levels, because potassium shifts inside the cells.  

• Monitor respirations as respiratory distress can occur.  

• Assess vital signs, intake and output, and monitor ketone levels

Diabetic Ketoacidosis Symptoms :

Diabetic ketoacidosis symptoms can appear quickly and may even be your first warning sign that you have diabetes. Symptoms include:

• Dry mouth

• Dry skin

• Feeling very thirsty

• Frequent peeing

• Nausea or vomiting

• Weakness

• Fatigue

• Confusion or less alertness

• Flushed face

• Headache

• Muscle aches

• Sweet-smelling breath

• Belly pain

• Shortness of breath

* if you have any of the symptoms below and your ketones are moderate to high when you test them using a home kit, or if you have more than one symptom.( go immediately to doctor ) :

• You've been throwing up for more than 2 hours.

• You feel queasy or your belly hurts.

• Your breath smells fruity.

• You're tired, confused, or woozy.

• You're having a hard time breathin

Risk factors for DKA include:

• Having type 1 diabetes, even if it’s undiagnosed

• Missing your insulin dose often

• Not taking your insulin as prescribed

• Stomach illness

• Infections

• Heart disease, such as a heart attack

• Recent stroke

• Blood clot in your lungs

• Serious illness or any trauma

• Pregnancy

• Surgery

• Medicines like steroids or antipsychotics

• Using illegal drugs, such as cocaine

Diabetic Ketoacidosis Treatment :

If you don't treat ketoacidosis, you could pass out, go into a coma, and possibly die. You should go to the hospital to treat DKA. There, you will receive emergency treatments like:

• Insulin through an IV to bring your ketones down

• Fluids to get you hydrated and bring your blood chemistry back into balance

• Electrolyte replacement through an IV to replace key minerals like sodium, potassium, and chloride to keep your heart, muscles, and nerves working properly

• If you have any infection, antibiotics

• If your doctor suspects you’re at risk for a heart attack, a further heart evaluation

Diabetic Ketoacidosis Complications :

DKA complications are possible if you don’t have emergency treatments like electrolyte replacement and insulin. They include:

• Low blood sugar or hypoglycemia

• Low potassium or hypokalemia

• Brain swelling (cerebral edema) if your blood sugar levels are adjusted too quickly

• Loss of consciousness

• Death