People with diabetes might be affected by DKA or Diabetic Ketoacidosis. This is a life-threatening problem that occurs when a persons body breaks down fat at a rate much too fast. Because of this, the liver will process fat into a fuel called ketones which makes the blood become acidic.
The Causes of Diabetic Ketoacidosis
DKA occurs when insulin gets so low in the body that one of the following occurs:
- Glucose or blood sugar can’t go into cells to be used as a fuel source
- The liver makes a huge amount of blood sugar
- Fat breaks down too quickly for the body to process
Your body’s fat is broken down by the liver called ketones as mentioned in the beginning. Ketones are typically produced when your body breaks down fat after having a long time between meals. However, when ketones produce too quickly they build up in the blood and urine and can become toxic by making the blood acidic. This is also known as ketoacidosis. In people undiagnosed with type 1 diabetes, DKA is sometimes their first sign. Though DKA can occur in someone who already has type 1 diabetes by infection, illness, missing insulin shot dosages, or surgery.
Those with type 2 diabetes may also develop DKA. However it is less common and less severe. DKA in those with type 2 diabetes is typically triggered by an uncontrolled blood sugar for a length of time, missing doses of medications, or illness/infection.
While symptoms differ by person to person, common symptoms include:
- Decreased Alertness
- Dry Skin and Mouth
- Deep, Rapid Breathing
- Flushed Face
- Fruity/Sweet Smelling Breathe
- Frequent Urination (Lasting longer than a day)
- Frequent Thirst (Lasting longer than a day)
- Muscle Stiffness or Aches
- Nausea and Vomiting
- Abdominal Pain
Tests and Exams
In those with type 1 diabetes, ketone testing may be used. This is to screen for early ketoacidosis and is done by a urine sample or a blood sample.
Other tests for ketoacidosis are:
- Arterial Blood Gas. This test is done by taking blood from an artery, but sometimes blood from a vein may be used.
- A Basic Metabolic Panel. This is a group of blood tests done to measure a persons sodium and potassium levels, along with kidney function, and other chemicals and functions.
- A Blood Glucose Test
- Blood Pressure Measurement
- Osmolality Blood Test. An osmolality test measures the concentration of all chemical particles found in the fluid section of blood. It can also be measured with a urine test.
There are two main goals for treatment. Goal one is to correct the high blood sugar level with insulin. Insulin reverses the process that causes diabetic ketoacidosis. Goal two is replacing fluids that have been lost through urination, loss of appetite, and vomiting but only if you have these symptoms. You may receive these orally but you could receive them through a vein until you are rehydrated.
As the body returns to normal your doctor might consider more testing just to check for possible triggers for DKA. But don’t worry! Your doctor will help you create a treatment plan and will prescribe anything needed to help you get back control of your diabetes.