which condition is also known as diabetic ketoacidosis?

which condition is also known as diabetic ketoacidosis?

which condition is also known as diabetic ketoacidosis?

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What is diabetic ketoacidosis?

Diabetic ketoacidosis (DKA) is a serious complication of type 1 diabetes and, much less commonly, of type 2 diabetes. DKA happens when your blood sugar is very high and acidic substances called ketones build up to dangerous levels in your body.

Ketoacidosis shouldn’t be confused with ketosis, which is harmless. Ketosis can occur as a result of an extremely low carbohydrate diet, known as a ketogenic diet, or from fasting.

DKA only happens when you don’t have enough insulin in your body to process blood sugar into energy. If this happens, your liver starts to process fat into energy, which releases ketones into the blood. High levels of ketones in the blood are dangerous.

It’s less common in people with type 2 diabetes because insulin levels don’t usually drop so low, but it can happen. DKA may be the first sign of type 1 diabetes, as people with this disease can’t make their own insulin.

which condition is also known as diabetic ketoacidosis?
which condition is also known as diabetic ketoacidosis?

Diabetic ketoacidosis Symptoms

Diabetic ketoacidosis signs and symptoms often develop quickly, sometimes within 24 hours. For some, these signs and symptoms may be the first indication of having diabetes. You may notice:

  • Excessive thirst
  • Frequent urination
  • Nausea and vomiting
  • Stomach pain
  • Weakness or fatigue
  • Shortness of breath
  • Fruity-scented breath
  • Confusion

More-specific signs of diabetic ketoacidosis — which can be detected through home blood and urine testing kits — include:

  • High blood sugar level
  • High ketone levels in your urine

DKA is a medical emergency. Call your local emergency services immediately if you think you may be experiencing DKA.

If left untreated, DKA can lead to a coma or death. or If you use insulin, make sure you discuss the risk of DKA with your healthcare team and have a plan in place.

If you have type 1 diabetes and have a blood sugar reading of over 240 milligrams per deciliter (mg/dL), you should test yourself for ketones using a urine or blood test.

You should also test if you are sick or planning on exercising and your blood sugar is 240 mg/dL or higher.

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Call your doctor if moderate or high levels of ketones are present. Always seek medical help if you suspect you are progressing to DKA.

People with type 2 diabetes are usually at lower risk of DKA. But the risk can increase when your body is under strain due to injury, infection, or surgery.

When to see a doctor

If you feel ill or stressed or you’ve had a recent illness or injury, check your blood sugar level often. You might also try an over-the-counter urine ketones testing kit.

Contact your doctor immediately if:

  • You’re vomiting and unable to tolerate food or liquid
  • Your blood sugar level is higher than your target range and doesn’t respond to home treatment
  • Your urine ketone level is moderate or high
which condition is also known as diabetic ketoacidosis?
which condition is also known as diabetic ketoacidosis?

Seek emergency care if:

  • Your blood sugar level is consistently higher than 300 milligrams per deciliter (mg/dL), or 16.7 millimoles per liter (mmol/L)
  • You have ketones in your urine and can’t reach your doctor for advice
  • You have many signs and symptoms of diabetic ketoacidosis — excessive thirst, frequent urination, nausea and vomiting, stomach pain, weakness or fatigue, shortness of breath, fruity-scented breath, and confusion


How is diabetic ketoacidosis treated?

The treatment for DKA usually involves a combination of approaches to normalize blood sugar and insulin levels.

If you receive a diagnosis of DKA but haven’t yet received a diagnosis of diabetes, your doctor will create a diabetes treatment plan to keep ketoacidosis from recurring.

Infection can increase the risk of DKA. If your DKA is a result of an infection or illness, your doctor will treat that as well, usually with antibiotics.

Fluid replacement

At the hospital, your physician will likely give you intravenous (IV) fluids to help your body rehydrate. During a DKA event, you usually lose a lot of fluids, which can reduce the amount of blood flowing through your body.

Fluid replacement helps restore typical blood flow. It also helps treat dehydration, which can cause even higher blood sugar levels.


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Electrolyte replacement

When your insulin levels are too low, your body’s electrolytes can also become atypically low.

Electrolytes are electrically charged minerals that help your body, including the heart and nerves, function properly. Electrolyte replacement is also commonly done through an IV.

Insulin therapy

Insulin will likely be administered to you through an IV until your blood sugar level falls below 200 to 250 mg/dLTrusted Source. The emergency care team will also monitor several other blood test results that indicate when insulin therapy is no longer needed.

When your blood sugar and other test readings are within an acceptable range, your doctor will work with you to help you avoid DKA in the future.

which condition is also known as diabetic ketoacidosis?
which condition is also known as diabetic ketoacidosis?

Who is at risk for developing diabetic ketoacidosis?

Risk factors for DKA include:

  • having type 1 diabetes
  • being a younger age, as research suggests 63 percent of DKA cases happen in people below the age of 51
  • physiologic shock, a life threatening condition caused by interrupted blood flow
  • emotional or psychological stress
  • acute cardiovascular disease, such as heart attack or stroke
  • acute gastrointestical illness, such as pancreatitis
  • having an alcohol use or drug use disorder
  • having an eating disorder
  • certain endocrine conditions, such as Cushing syndrome and hyperthyroidism
  • recent surgery
  • pregnancy


Certain medications can increase the risk of DKA. These include:

  • some antipsychotic medications, such as clozapine (Clozaril), olanzapine (Zyprexa), and risperidone (Risperdal)
  • corticosteroids
  • thiazide diuretics

Ketosis-prone diabetes

Although DKA is less common in people who have type 2 diabetes, it does occur. Some people with type 2 diabetes are considered “ketosis-prone” and are at a higher risk of DKA. A diagnosis of ketosis-prone diabetes is more likelyTrusted Source for:

  • Black (African American, Afro Caribbean, and sub-Saharan African), Asian (Chinese, Indian, and Japanese), and Hispanic people
  • people who have overweight or obesity
  • people who are middle-aged
  • males

It’s best to talk with your doctor about your risk factors to make sure you have the right treatment plan in place.

which condition is also known as diabetic ketoacidosis?
which condition is also known as diabetic ketoacidosis?

Preventing diabetic ketoacidosis

There are many ways to prevent DKA. Prevention means following your diabetes treatment plan carefully and taking some extra care when you’re sick.

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Follow your treatment plan

You can lower your risk of DKA with proper management of your diabetes:

  • Take your medications as directed, even if you’re feeling fine.
  • Follow your meal plan.
  • Test your blood sugar consistently, as recommended by your doctor. This will help you get in the habit of making sure your numbers are in range. If you notice a problem, you can talk with your doctor about adjusting your treatment plan.
  • Talk with your doctor about adjusting your insulin dosage levels based on your activity level, illnesses, or other factors, such as what you’re eating.
  • If you have high blood sugar and your blood or urine test detects ketones, do not exercise. Exercising with high blood sugar can be dangerous when you have diabetes. It’s best to talk with your doctor about how to manage this situation.
  • Sometimes the cost of insulin can make it more difficultTrusted Source to follow a diabetes treatment plan.

When you’re sick

Although you can’t completely avoid illness or infection, you can take steps to help you remember to take your insulin and to help prevent and plan for a DKA emergency.

A “sick day plan” can reduce the risk of DKA:

  • Test for ketone levels when you’re sick. This can help you catch mild to moderate ketone levels before they threaten your health.
  • Set an alarm if you take your medication at the same time every day, or use a reminder tool like a phone app.
  • Ask your doctor or pharmacist if it’s okay to prefill your syringe or syringes in the morning. That will help you easily see if you missed a dose.
  • Take the medications advised by your healthcare team to treat fever or infection.
  • Have soft or liquid foods available that are easier to eat if you become nauseous.
  • If there’s someone helping to care for you when you’re sick at home, make sure they have information about your diabetes treatment plan, including your medication and testing schedules.

Call your doctor if you detect moderate or high ketones in a home test. If you can’t reach your doctor and you suspect you may be progressing to DKA, get emergency help. Early detection is essential.

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