Diabetic Ketoacidosis is a serious complication of diabetes which occurs in people with type 1 diabetes. A lack of insulin, results in high concentrations of blood sugar, progressive dehydration and collapse. It also causes uncontrolled breakdown of fat stores which results in the liver being overwhelmed leading to large amounts of ketoacids being released into the circulation. High levels of blood acidity is harmful to he body and causes damage to organs and death if not treated in time.
Ketoacidosis results from an absolute deficiency of insulin. There is also a concomitant rise in various hormones which oppose insulin. People with type 1 diabetes develop ketoacidosis for a variety of reasons.
Common infections include pneumonia, urinary infections and gastrointestinal infections.
The condition progresses rapidly with increasing dehydration, falling blood pressure, hyperventilation and low body temperature.
Yes, if not treated in time ketoacidosis may lead to shock, kidney failure, multiple organ failure and death.
Treatment consists of
Management of DKA requires admission to hospital and it is an indication of the gravity of this condition that many centres routinely admit patients to a high dependency unit or intensive care unit.
Yes. Many patients do get recurrent attacks of DKA. It is particularly common in teenagers who for various reasons miss out on their doses of insulin.
Dr Nishan Wijenaike, Consultant Physician
West Suffolk Hospitals Diabetes Service