Diabetic Ketoacidosis Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Diabetic ketoacidosis is one of the serious complications of diabetes. This term is used to describe a state of metabolic decompensation marked by hyperglycemia, acidosis, and ketosis.
Diabetic ketoacidosis is caused by absolute or relative insulin deficiency. So, this condition occurs when the body does not produce enough insulin to absorb glucose into the body’s cells and turn it into energy.
This disorder generally attacks patients with Diabetes Mellitus type 1, although it can also attack patients with Diabetes Mellitus type 2. In addition, this condition can also be experienced by people who do not realize that they have diabetes.
Symptoms
A person with diabetic ketoacidosis will show various symptoms, such as:
- Poluria (frequent urination)
- Polydipsia
- Fast and deep breathing (Kussmaul breathing)
- Dehydration or lack of fluids (lower skin turgor pressure, dry tongue and lips)
- Breath smells of acetone or fruit
- Signs of infection such as fever, shortness of breath, vomiting, and abdominal pain
Cause
Diabetic ketoacidosis can be caused by various things, including:
- Insulin is not given or is given with an insufficient dose.
- Infection can aggravate the occurrence of diabetic ketoacidosis. Some types of infection that usually worsen this condition include pneumonia, urinary tract infection, or focus of infection elsewhere.
- Irregular treatment.
- Other causes – such as hyperthyroidism, pancreatitis, and corticosteroid treatment.
Diagnosis
The diagnosis of diabetic ketoacidosis is made by a doctor through a detailed medical interview to see the symptoms experienced by the sufferer and through a physical examination. At the medical interview, the sufferer should explain honestly if there is a history of stopping the diabetes medication that he usually uses.
The doctor will also see various symptoms of infection such as fever, congestion, cough or painful urination. At the blood sugar test, the doctor will get a high blood sugar level, usually above 250 mg/dl.
To determine the diagnosis of diabetic ketoacidosis, the following three findings are required:
- Hyperglycemia or high blood sugar (blood sugar above 250 mg/dl)
- Acidosis or acidic blood (blood pH <7.3, HCO3 level <18mEq/L)
- Ketosis, the presence of ketones in the blood
Treatment
Diabetic ketoacidosis is a serious condition that requires quick and accurate treatment in the emergency department. The goal of treating diabetic ketoacidosis is to improve circulation and tissue perfusion, as well as stop ketogenesis by giving insulin.
As an initial step, fluid resuscitation will be performed to replace the patient’s lack of fluid. If the patient’s heart condition is good, then it can be considered giving fluids as much as 10% of the ideal body weight.
But the replacement of body fluids must be adapted to the individual conditions of each person. Giving excessive fluids to patients with heart disorders is not recommended. Correction of various other metabolic disorders is also necessary, such as electrolyte and acid-base disorders.
In addition to giving fluids, insulin is a necessary therapy to lower the patient’s blood sugar. Administer insulin as an intravenous injection with strict blood sugar monitoring to prevent hypoglycemia. Diabetic ketoacidosis patients should be carefully examined for the search for triggering factors, such as infection.
Prevention
Prevention of diabetic ketoacidosis is done by giving diabetes medication in sufficient doses and preventing infection. Controlling the blood sugar of diabetics not only reduces the risk of acute complications of diabetes such as diabetic ketoacidosis but will also reduce chronic complications such as heart disease and stroke.