Diabetic Ketoacidosis

Diabetic ketoacidosis occurs when the body cannot produce enough insulin to convert all the sugar in the food into energy. This creates a deficit of energy in the body. Our liver then fulfils this energy deficit by processing high amounts of fat into energy. The by-product of this process is ketones, which are then released into our bloodstream. When acid levels increase, the blood becomes acidic, and the condition is diagnosed as diabetic ketoacidosis. 

Diabetic ketoacidosis, if not treated on time, can cause serious health complications such as organ damage, stroke, coma or even death. It is important to seek the correct diabetic ketoacidosis treatment to prevent these. If you are at the risk of diabetes, you should always be on the lookout for symptoms of diabetic ketoacidosis and seek medical care immediately. With timely diabetic ketoacidosis treatment, the risk of related health complications can be reduced.

Symptoms of Diabetic Ketoacidosis

Diabetic ketoacidosis symptoms often develop within 24 hours. Some of them are-

• Excessive thirst 
• Frequent urination
• Stomach pain
• Nausea and vomiting
• Shortness of breath
• A dizzy feeling or confusion
• Weakness or fatigue
• Fruity smelling breath
• Dry skin
• Unconsciousness

People with diabetic ketoacidosis experience 3 or more of these symptoms at a time. However, they often confuse diabetic ketoacidosis symptoms with that of common diabetes. At such times, you should seek immediate medical treatment if-

• Your blood sugar levels are higher than usual and not responding to home remedies
• You are constantly vomiting and unable to keep down solids or liquids
• You experience fruity-smelling breath
• Your at-home ketone kit indicates high levels of ketones in your urine 
• You feel dizzy or confused
• You are having difficulty breathing

Having type 1 diabetes immediately puts you at the greater risk of diabetic ketoacidosis. If your sugar level reads above 240 mg/dL, you can use an at-home ketone measuring urine strip or get a blood test done. High levels of ketones are an indication of diabetic ketoacidosis.

Treatment of Diabetic Ketoacidosis

Diabetic ketoacidosis can cause organ damage, coma or even death if not managed properly. Therefore, it is important to diagnose the condition at the earliest and receive timely treatment for the same. 

There are many treatments currently available for diabetic ketoacidosis management. All of them require a trip to the emergency room or hospital stay. Most of these treatments will help stabilise your blood sugar levels by normalising the insulin levels. Here are the top three diabetic ketoacidosis treatments-

Fluid replacement

Fluid replacement is a common diabetic ketoacidosis management technique that involves replenishing the body with fluids intravenously. This is to make up for all the lost fluids in the body because of vomiting and excessive urination. Dehydration is another major cause of the rise in blood sugar levels.

Replacing fluid in the body restores blood flow, reducing the ketones levels in the blood. It also helps dilute the excess sugar in the blood. Once your blood sugar levels have normalised and there are no ketones found in the urine, you will be discharged.

Electrolyte replacement

Another method for diabetic ketoacidosis management is electrolyte replacement. It is used to replace the lost electrolytes in the body. These electrolytes have rather important functions in the body. These are electrically charged minerals that carry sodium, potassium and chloride, which are required for the heart, nerves and muscle cells to function normally.  Lower levels of insulin in the body cause a drop in the level of electrolytes as well. In the case of diabetic ketoacidosis, these will be administered through an IV. In the case of diabetic ketoacidosis, your doctor may put you on an insulin IV until your blood sugar levels fall below 200-250 mg/dL.

Normalising the insulin levels in the body will directly reduce the ketones in the blood. Once there are no traces of ketones found in the body and your blood sugar levels are normal, you will be discharged. Furthermore, your doctor may advise you on various methods of diabetic ketoacidosis management to prevent such episodes in the future.

Causes of diabetic ketoacidosis

Diabetic ketoacidosis is usually the result of abnormally high sugar levels in the body, which is because of low insulin levels. When insulin is deficient in the body, the glucose in the blood is not converted into energy. This creates a deficit of energy in the body. Our liver then breaks down the stored fat cells to release energy. This process happens so rapidly that it releases acids into the bloodstream. These acids, known as ketones, turn the blood acidic, causing a host of other problems in the body. 

Some common diabetic ketoacidosis causes are-

• Missing an insulin injection or a malfunctioning insulin pump for patients using one
• An illness or an infection where the body produces cortisol. This suppresses the production of insulin in the body.
• Alcohol abuse or the high use of drugs such as cocaine.
• Certain medications such as corticosteroids or diuretics

Who is at risk of diabetic ketoacidosis?

Diabetic ketoacidosis is common in people with any of the following conditions- 

• Type 1 diabetes
• A recent injury, accident or trauma, causing problems in the blood flow in the body.
• A stroke or a heart attack
• Eating disorder
• Alcohol or drug abuse
• Pancreatitis

How do you test for diabetic ketoacidosis?

The first step towards diabetic ketoacidosis diagnosis is to check the level of ketones in the urine. If you have been diagnosed with type 1 diabetes, you should have a supply of ketone test kits handy at home. You can use this to check your blood or your urine for ketone levels.

It is recommended to conduct a ketone test at home if-

• Your blood sugar levels exceed 250 mg/dL
• You are vomiting and telling dizzy
• You experience fruity breath

How to use a ketone test strip at home?

Ketone urine test strips help indicate the level of ketones in the urine by changing colour. The strip will change colour once you pee on it. The test kit will contain a result chart. Compare your results with the chart to understand the approximate amount of ketone level in your urine.

There are blood ketone test kits also available to help you with diabetic ketoacidosis diagnosis. These will test both your sugar as well as ketone levels in your blood.

How can you prevent diabetes ketoacidosis?

It is easy to prevent diabetic ketoacidosis complications by keeping your blood sugar levels in check and acting immediately if you notice any of the above-mentioned symptoms of diabetic ketoacidosis. Here are a few ways in which you can lower your risk of diabetic ketoacidosis- 

• Never skip your insulin shots
• Follow the diet plan given by your doctor
• Be consistent in checking your blood sugar levels
• Check for ketone levels in case you notice any signs of diabetic ketoacidosis.

Bottomline

Managing diabetes ketoacidosis is quite easy if you inculcate healthy eating habits in your daily routine and strictly follow a diabetic-friendly diet. It is always advised to consult your doctor and avoid self-medicating or increasing/decreasing the dose of insulin that is recommended to you as it can harm your health. A good diet, an active lifestyle and following your doctor’s advice can help you effectively manage diabetic ketoacidosis.

FAQs

What is the Treatment for Diabetic Ketoacidosis?

Treatment for diabetic Ketoacidosis involves three main lines:

• IV fluids: Keep you hydrated and replenish fluid loss
• IV electrolytes: Replenish levels of electrolytes (sodium, potassium, and chloride) and ensure proper function of heart, kidney, muscle, and nerves
• IV Insulin: Regulates blood glucose levels and clears excess ketone bodies from your blood

What is the initial treatment for Diabetic Ketoacidosis?

Initial treatment for diabetic ketoacidosis aims to correct electrolyte imbalance and provide insulin therapy for quicker resolution and prevention of complications. Fluid replacement is also an integral part of initial treatment.

Is Diabetic Ketoacidosis Curable?

Diabetic ketoacidosis is curable but with a clause. If diagnosed early, diabetic ketoacidosis is treatable using standard medical care along with a possible requirement for additional therapies. However, the clause is that you need to follow the doctor’s advice and also adhere to certain lifestyle behaviors to avoid the occurrence of diabetic ketoacidosis in the future. Becoming aware and understanding the risk associated with diabetic ketoacidosis is also crucial.

How is Early Ketoacidosis Treated?

Early ketoacidosis treatment is based on symptoms and could involve IV infusion of fluids, electrolytes, and insulin therapy to reduce ketone bodies from blood. Your doctor might also advise you to follow a strict diet plan and exercise regime to regulate blood sugar levels based on the severity of the ketoacidosis.

What is ketoacidosis?

Ketoacidosis is a life-threatening metabolic condition of diabetes mellitus. This can happen suddenly to a person and if not taken seriously it may cause a diabetic coma or death. When a person experiences this condition, the body extensively undergoes the breakage of fats into acidic ketones. This acidic nature of ketones causes the human blood to become extremely acidic and such a condition is known as diabetic ketoacidosis. This condition is caused when the body does not utilize the hormone insulin which declines the cells to utilize glucose properly and causes the sudden breakage of fats along with the liver producing excessive blood glucose.

Type 2 diabetes ketoacidosis symptoms?

Diabetic ketoacidosis condition is less severe in type 2 diabetic people. People with type two diabetes may get ketoacidosis due to unmanaged blood sugar levels for a long period. However, if one experiences this condition then symptoms like frequent thirst and urination, dry skin, abdominal and muscle pain, fatigue, weakness, headache, nausea, vomiting, dyspnea, sweet-smelling breath, etc.