Summary about Disease
Diabetic ketoacidosis (DKA) is a serious complication of diabetes that occurs when the body produces high levels of blood acids called ketones. It develops when the body doesn't have enough insulin to allow blood sugar (glucose) into your cells for use as energy. Instead, your liver breaks down fat for fuel, producing ketones. Excess ketones build up in the blood and urine, becoming dangerous. DKA requires prompt medical treatment.
Symptoms
Excessive thirst
Frequent urination
Nausea and vomiting
Abdominal pain
Weakness or fatigue
Shortness of breath
Fruity-scented breath
Confusion
High blood sugar levels
High ketone levels in your urine
Causes
Insulin deficiency: The primary cause is a lack of insulin, either due to missed insulin injections, malfunctioning insulin pumps, or the body's inability to produce enough insulin (as in newly diagnosed type 1 diabetes).
Illness: Infections, such as pneumonia or urinary tract infections, can cause the body to release hormones that counteract insulin, leading to DKA.
Stress: Physical or emotional stress can also trigger the release of these counter-regulatory hormones.
Other factors: Heart attack, stroke, pancreatitis, and certain medications can also contribute.
Medicine Used
DKA treatment involves several medications:
Insulin: Administered intravenously (IV) to lower blood sugar levels and stop ketone production.
Fluids: IV fluids are given to correct dehydration caused by excessive urination and vomiting.
Electrolytes: Potassium, sodium, and phosphate are often given intravenously to correct electrolyte imbalances.
Is Communicable
No, diabetic ketoacidosis is not a communicable disease. It is a metabolic complication of diabetes and cannot be transmitted from person to person.
Precautions
Preventing DKA involves careful diabetes management:
Monitor blood sugar regularly: Check blood sugar levels frequently, especially during illness or times of stress.
Take insulin as prescribed: Adhere to your insulin regimen and adjust dosages as needed based on blood sugar levels and advice from your healthcare provider.
Stay hydrated: Drink plenty of fluids, especially when blood sugar is high or during illness.
Check ketone levels: Use ketone test strips to check urine for ketones when blood sugar is high or when feeling unwell.
Seek medical attention promptly: Contact your doctor or go to the emergency room if you suspect DKA symptoms.
Sick-day plan: Follow your sick-day plan, as outlined by your healthcare provider, when you are ill.
Insulin Pump Users: Check insulin pump is working properly and site is not infected.
How long does an outbreak last?
DKA is not an "outbreak" in the traditional sense of an infectious disease. The duration of DKA depends on how quickly it is diagnosed and treated. With prompt medical intervention, blood sugar and ketone levels can typically be brought back to normal within 24-48 hours. However, the underlying cause of DKA (e.g., infection) may prolong the overall recovery period.
How is it diagnosed?
DKA is diagnosed through a combination of physical examination and laboratory tests:
Blood glucose test: Measures blood sugar levels.
Ketone test: Measures ketone levels in the blood or urine.
Arterial blood gas (ABG) test: Measures the pH of the blood and levels of oxygen and carbon dioxide, helping to assess the severity of acidosis.
Electrolyte panel: Measures electrolyte levels (sodium, potassium, chloride) in the blood.
Complete blood count (CBC): May be performed to look for signs of infection.
Timeline of Symptoms
The timeline of DKA symptoms can vary depending on the individual and the underlying cause. In some cases, symptoms may develop rapidly, over a few hours. In other cases, they may develop more gradually, over a day or two. A general timeline might look like this:
Early: Increased thirst and urination, fatigue
Intermediate: Nausea, vomiting, abdominal pain, weakness
Late: Fruity-scented breath, shortness of breath, confusion, loss of consciousness It's important to note that not everyone will experience all of these symptoms, and the order in which they appear can vary.
Important Considerations
DKA is a medical emergency: Prompt treatment is essential to prevent serious complications, such as cerebral edema, coma, and death.
Education is key: People with diabetes and their families should be educated about the signs and symptoms of DKA, as well as how to prevent it.
Underlying cause: Identifying and addressing the underlying cause of DKA is crucial to preventing future episodes.
Communication with healthcare team: Regular communication with your healthcare team is important to manage your diabetes effectively and prevent complications like DKA.
Type 1 Diabetes Risk: Individuals with type 1 diabetes are at a higher risk of developing DKA, particularly if insulin is not taken regularly.
Cost: DKA can be costly due to hospitalization and treatment. Prevention through proper diabetes management is economically beneficial.