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Ketoacidosis is one of the serious complications of diabetes that can be life threatening. It is a state in which energy is not produced by burning fat, but by burning glucose. Ketoacidosis is a direct consequence of insulin deficiency. The disease is a consequence of untreated or improperly treated diabetes.
Definition of ketoacidosis
Ketoacidosis is a very life-threatening complication of diabetes. It can occur in any of its types, but the greatest risk is for type I diabetics. Where does this complication come from? From insufficient or lack of insulin.
Insulin helps your body’s cells take up sugar in the blood so that they can use it as an energy source. Therefore, the lack of adequate amount of insulin or its complete deficiency makes sugar intake impossible. This state of affairs causes the excess sugar to accumulate in the blood and, at the same time, the lack of it in the cells. Cells begin to look for other sources of energy that are found in adipose tissue (then fats are broken down, the side effect of which is ketone bodies accumulating in the body).
Ketone bodies are a risk because they are acidic and interfere with vital processes – this type of disorder is called ketoacidosis.
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Important! Not always a high amount of glucose in the blood causes ketoacidosis. It happens that sugar levels return to normal after giving the right dose of insulin. Ketoacidosis occurs when high blood sugar levels, ie> 250 mg / dL (14 mmo / L), last for several hours.
What causes ketoacidosis?
Ketoacidosis can occur as a complication in the course of any type of diabetes (most often in type 1 diabetes). There is a group of factors that may have a significant impact on the appearance of ketoacidosis, because the level of insulin in the body depends on their occurrence. Lack of insulin leads to the activation of an alternative source of energy, i.e. fats, the intensified decomposition of which leads to the formation of ketone bodies.
- treatment errors: that is, situations in which you miss a dose or stop using insulin or oral diabetes medications;
- bacterial infections (especially purulent),
- acute cardiovascular diseases (i.e. heart attack, stroke),
- acute pancreatitis,
- alcohol abuse,
- eating disorders,
- delayed diagnosis of diabetes,
- other conditions of increased insulin requirement.
Ketoacidosis – symptoms
The symptoms of ketoacidosis include:
- excessive thirst, dry mouth, polyuria, weakness (due to dehydration and metabolic disorders),
- Kussmaul’s acidic breathing, meaning fast and deep, then shallow breathing; the smell of acetone from the mouth (related to the excessive production of ketone bodies and the attempt to excrete them from the body through the lungs – a characteristic smell reminiscent of the smell of apples),
- disturbance of consciousness up to coma (resulting from the toxic effect of ketone bodies on the brain tissue),
- reddening of the cheeks – acidic flushing (related to the widening of blood vessels that occurs in acidosis),
- dizziness and headaches; nausea and vomiting;
- stomach and chest pain.
What is first aid for ketoacidosis?
If there is a person with ketoacidosis in your environment – call an ambulance. If the patient is conscious, they should be given fluids, preferably water with lemon, which has a deacidifying effect and balances the level of ions in the body. It should not be given in large amounts at once, as this may provoke vomiting in the patient.
Ketoacidosis – diagnosis and treatment
The diagnosis of ketoacidosis is made by a doctor based on the presence of appropriate clinical symptoms, physical examination and blood tests performed in the hospital. It is performed, among other things gasometrywhich allows you to detect acid-base imbalances. If the patient has ketoacidosis, the blood gas measurement is pH <7,3 or HCO03 (plasma bicarbonate) <15 mmol / L, and blood glucose is> 250 mg / dL (14 mmo / L). In addition, it is moving out urine testto assess the presence of ketone bodies. Due to the serious condition, the treatment is carried out in a hospital setting and consists in adequate hydration, lowering blood glucose levels, elimination of ketone bodies, correction of water and electrolyte disturbances and acid-base balance, as well as comorbidities (i.e. treatment of infections).
Complications
Untreated ketoacidosis can lead to a diabetic coma and even death, so it is very important to see your doctor as soon as possible.
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