Why is dka bad

DKA mainly affects people with type 1 diabetes , but can sometimes affect people with type 2 diabetes. If you have diabetes, it's important to be aware of the risk and know what to do if you get DKA. You can get DKA if you have high blood sugar hyperglycaemia and a high level of ketones in your blood or urine. You can check your ketone levels using a home-testing kit. Call your diabetes team or GP as soon as possible if you're not sure whether you need emergency help — for example:.

For example, pneumonia and urinary tract infections are common DKA triggers. Having a diet low in carbohydrates is a risk factor for ketosis. This may be purposeful, for instance, as a weight-loss strategy. People on restrictive diets or people with an eating disorder may be at a higher risk for ketosis.

Type 1 diabetes is the main risk factor for DKA. In one study of people with DKA, researchers found that 47 percent had known type 1 diabetes, 26 percent had known type 2 diabetes , and 27 percent had newly diagnosed diabetes.

If you have diabetes, a main risk factor for DKA is not following the routine for blood sugar management that your doctor recommends. Researchers looked at diabetes in children and teenagers. They found that one in four participants had DKA when their doctor first diagnosed them with diabetes. Additional risk factors include:. You can get a simple blood test to detect the level of ketones in your blood.

You can use the level of ketones to determine if you have ketosis or DKA. You may also be able to take a urine test at home. It will change colors based on the level of ketones in your urine. Blood ketone tests are the ideal method for diabetics to check ketone levels because they measure the levels of beta-hydroxybutyric acid, the primary ketone involved in ketoacidosis.

You should go to your doctor or the emergency room immediately for evaluation and treatment if you have diabetes, or you take care of someone with diabetes, and you notice any of the symptoms of DKA. Call if the symptoms worsen quickly. Your doctor will perform a physical exam. The results from your blood test can help your doctor determine if you have DKA or other complications of diabetes. Your doctor may also perform:. Illness can affect diabetes and increase your blood sugar level.

You can monitor blood sugar and ketones with over-the-counter test kits. You can monitor your blood sugar using a blood test strip, and you can test for ketones using a urine test strip. Doctors originally developed the ketogenic diet to treat children with epilepsy. According to the Epilepsy Foundation , studies show that more than 50 percent of children who try the diet have half the number of seizures or fewer, while 10—15 percent become seizure-free. Doctors do not know why the ketogenic diet reduces some symptoms of epilepsy.

In contrast, ketoacidosis occurs when the body thinks that it is starving and starts breaking down fats and proteins too quickly. It is a potential complication of type 1 diabetes. If a person does not have enough insulin , the body cannot move glucose from the blood into cells, where it is necessary for energy. As a result, dangerous levels of both glucose and ketones can accumulate in the blood.

Doctors refer to this condition as diabetic ketoacidosis. Doctors can use blood and urine tests to determine whether a person is in ketosis or ketoacidosis. During nutritional ketosis, it is normal to have blood ketone levels of 0. People with diabetes whose blood ketone levels are high have a more significant risk of diabetic ketoacidosis. Diabetic ketoacidosis is a potential complication of type 1 diabetes, and it can occur if a person does not administer enough insulin at the right times.

Not eating enough food can also sometimes trigger diabetic ketoacidosis. The symptoms of diabetic ketoacidosis include :. As ketoacidosis progresses, symptoms can include :.

For most people, ketosis is a short-lived metabolic state that happens when the body temporarily switches from burning glucose to burning fat. During this time, the level of ketones in the blood rises. People on ketogenic diets aim to spend more extended periods in ketosis.

Some people also enter a state of ketosis through fasting. Ketosis can lead to bad breath and weight loss. Administer the normal saline based on the blood pressure and other indicators of tissue perfusion. It would be acceptable to bolus the fluid in cases of severe hypovolemia and hypotension. Also be sure to place the patient on a continuous cardiac monitor and obtain and record the blood glucose level. Continuously reassess the patient for improvement or deterioration. By understanding the pathophysiology of diabetic ketoacidosis, you should be better prepared to recognize the clinical presentation more promptly, differentiate the condition from other diabetic emergencies and have a good foundation for understanding the emergency care necessary to manage the patient effectively.

Joseph J. He has more than 36 of experience as an EMS educator. He is a frequent speaker at state and national EMS clinical and education conferences.

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There are three major pathophysiologic syndromes associated with an excessively elevated blood glucose level in DKA: Metabolic acidosis Osmotic diuresis Electrolyte disturbance Due to the lack of insulin, cells are not receiving an adequate fuel source to produce energy.

The DKA patient is therefore prone to metabolic acidosis from: Ketone production Severe dehydration from osmotic diuresis Electrolyte disturbances These three pathophysiologic syndromes produce the signs and symptoms exhibited by the patient.

DKA emergency care and management As with any patient in the prehospital environment, ensure an adequate airway, ventilation, oxygenation and circulation. Guyton, A. Textbook of Medical Physiology. Philadelphia: W. Sauders,