Causative & risk factors
DKA usually occurs in people with type 1 diabetes but it can also occur with type 2 diabetes.
The trigger factors for development of DKA are extremely high blood sugar levels combined with little or no insulin or dehydration, stress, any severe illness or infection, high fever, substance abuse or undergoing any form of surgery. In DKA, the body starts breaking down its own muscles.
Clinical presentation
The symptoms of diabetic ketoacidosis develop very quickly. The skin becomes red, warm and dry. The patient’s thirst and urinary frequency increases. He becomes confused and drowsy. He may start taking rapid, deep breaths and develop a strong fruity odor to his breath. He may also experience pain in the abdomen, vomiting and loss of appetite. Electrolyte imbalance may occur. Untreated diabetic ketoacidosis can even lead to death.
Investigations
The blood sugar levels, ketone levels and pH levels will be measured. Urine examination will be carried out to measure ketone bodies. The serum electrolyte levels will be monitored. Renal functions testing is done.
Treatment
Patients with diabetic ketoacidosis must be hospitalized. Intravenous fluids and insulin are administered to keep blood sugar levels in the normal range. Electrolytes are given if necessary especially potassium.
