Diabetes Control Matters
What Is Diabetic Ketoacidosis?
Diabetic Ketoacidosis (DKA) is a long scientific term that
you probably never really wanted to understand. But it is
a dangerous health condition and is completely preventable.
If you have Type 1 diabetes, high blood glucose can lead to
DKA (It is rarely a problem for Type 2 diabetes).
When the body cannot use sugar for energy because of lack
of insulin, the body breaks down fat for energy and ketones
are made. Ketones are the acids or toxins produced when blood
glucose rises in the absence of insulin. Large amounts of
ketones in the blood cause the life-threatening problem called
diabetic ketoacidosis. When high levels of ketones are in
the blood, the ketones spill into the urine, just as sugar
does. Your whole body becomes too acid: in other words, you
have acidosis. Common causes of KDA include: illness, infection,
"bad" insulin, and/or missed doses of insulin.
Unfortunately, the most common cause of DKA is the mistaken
impression that when you are sick and not eating, you should
stop taking your insulin. Illness actually increases your
need for insulin, and omitting insulin during the stress of
an illness can vary and quickly lead to DKA.
Symptoms of DKA
- Increased thirst & urination
- Nausea, vomiting, and or stomach pain
- Changes in or difficulty breathing
- Acid or fruity smell on breath
- Flushing
- Dehydration
- Passing out
- Fatigue
How Can You Prevent DKA?
- Follow sick day guidelines.
- Never stop taking your usual insulin dose.
- Test blood glucose ever 2 – 4 hours.
- If you do not have a plan to take extra insulin,
call your physician if you have 2 unexplained bloodsugars
in a row of over 240 mg/dl.
- If your blood glucose is over 240, check your
urine for ketones.
- If ketones are present, call your physician right
away.
- Avoid exercise until ketones disappear or your
blood sugar is less than 300mg/dl.
- It is important to increase fluid intake –
drink sugar-free, caffeine-free fluids such as water, diet
soda, broth or tea.
- If persistent vomiting, inability to tolerate
fluids by mouth, or persistent diarrhea with progressive
weakness is present, call your doctor immediately.
How Is DKA Treated?
DKA is usually treated under medical supervision in the hospital.
Treatment includes:
- Insulin
- Fluids
- Correction of acidosis (especially potassium)
- Usually an IV is started
- Careful monitoring
- Treatment of the cause
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