Diabetic ketoacidosis (DKA, a complication of poorly controlled diabetes)

Description Occurs when there i...

Description

Occurs when there is not enough circulating insulin. This lack of insulin causes elevated glucose levels in the blood and forces the body to breakdown body fats for energy. This results in a buildup of ketones. The increased ketones increases the acidity of the blood and when severe can result in coma and death. This disorder is also called diabetic ketoacidosis (DKA) and is most often associated with diabetes type 1. The most common causes of DKA are not taking the correct amounts of insulin and a secondary stress to the body such as an infection, surgery or trauma.

Symptoms

Fatigue, frequent urination, increased thirst, fruity breath odor, confusion, coma, muscle stiffness or aching, nausea, vomiting, rapid breathing, shortness of breath.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical exam will be performed. Blood tests, urine tests and X-rays are done to determine why the glucose is elevated since an infection can cause dramatic increase in glucose. The severity of diabetic ketoacidosis is evaluated by measuring the acid and base and electrolyte status of the blood.

Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), Urinalysis (UA)

Other Specific Tests: Serum ketones, arterial blood gas

Specialists:
Internal Medicine, Diabetes, Endocrinology and Metabolism, Pediatric Endocrinology

Treatment

Intravenous fluids and insulin are the mainstays of therapy. Correction of metabolic abnormalities such as low sodium or potassium is necessary as well. Treatment of the cause of the DKA must also be reversed.