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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] A person's breath may develop a specific "fruity" or acetone smell. [1]
Diabetic ketoacidosis (DKA) is one of the life-threatening severe complications of diabetes that demands immediate attention and intervention. [7] It is considered a medical emergency and can affect both patients with T1D (type 1 diabetes) and T2D (type 2 diabetes), but it is more common in T1D. [8]
As patients are likely to initially present in DKA, the acute management of DKA is the first priority. The treatment of DKA in KPD is identical to the treatment of DKA caused by type 1 diabetes and revolves around fluid repletion, electrolyte repletion, and administration of insulin. [ 7 ]
The most common cause of ketoacidosis is a deficiency of insulin in type 1 diabetes or late-stage type 2 diabetes. This is called diabetic ketoacidosis and is characterized by hyperglycemia, dehydration and metabolic acidosis. Other electrolyte disturbances such as hyperkalemia and hyponatremia may also be present.
If the patient is known to have diabetes, the diagnosis of diabetic ketoacidosis is usually suspected from the appearance and a history of 1–2 days of vomiting. The diagnosis is confirmed when the usual blood chemistries in the emergency department reveal a high blood sugar level and severe metabolic acidosis.
The most common causes of high anion gap metabolic acidosis are: ketoacidosis, lactic acidosis, kidney failure, and toxic ingestions. [3] Ketoacidosis can occur as a complication of diabetes mellitus (diabetic ketoacidosis), but can occur due to other disorders, such as chronic alcoholism and malnutrition. In these conditions, excessive free ...
The advocacy organization Ketotic Hypoglycemia International defines pathologic ketotic hypoglycemia as recurrent, symptomatic episodes in which patients have beta-hydroxybutyrate levels ≥ 1.0 mmol/L and blood glucose levels < 70 mg/dL in the absence of triggers that would otherwise explain ketotic hypoglycemia. [2]
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.