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Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. [1] Signs and symptoms may include vomiting , abdominal pain , deep gasping breathing , increased urination , weakness, confusion and occasionally loss of consciousness . [ 1 ]
Kussmaul breathing is a deep and labored breathing pattern often associated with severe metabolic acidosis, particularly diabetic ketoacidosis (DKA) but also kidney failure. It is a form of hyperventilation , which is any breathing pattern that reduces carbon dioxide in the blood due to increased rate or depth of respiration.
Blood tests for the diagnosis of diabetic ketoacidosis measure glycemia (sugar level), pH (blood acidity), and ketone bodies. As urgent medical treatment is often required when DKA is suspected, the tentative diagnosis can be made based on clinical history and by calculating the anion gap from the basic metabolic panel , which would demonstrate ...
The anion gap can be increased due to relatively low levels of cations other than sodium and potassium (e.g. calcium or magnesium). An anion gap is usually considered to be high if it is over 12 mEq/L. High anion gap metabolic acidosis is typically caused by acid produced by the body.
Metabolic acidosis is a serious electrolyte disorder characterized by an imbalance in the body's acid-base balance.Metabolic acidosis has three main root causes: increased acid production, loss of bicarbonate, and a reduced ability of the kidneys to excrete excess acids. [5]
Ketogenesis takes place in the setting of low glucose levels in the blood, after exhaustion of other cellular carbohydrate stores, such as glycogen. [10] It can also take place when there is insufficient insulin (e.g. in type 1 (and less commonly type 2) diabetes), particularly during periods of "ketogenic stress" such as intercurrent illness. [4]
The anion gap [1] [2] (AG or AGAP) is a value calculated from the results of multiple individual medical lab tests.It may be reported with the results of an electrolyte panel, which is often performed as part of a comprehensive metabolic panel.
Ketosis is a metabolic state characterized by elevated levels of ketone bodies in the blood or urine. Physiological ketosis is a normal response to low glucose availability. In physiological ketosis, ketones in the blood are elevated above baseline levels, but the body's acid–base homeostasis is maintained.