Page 103 - Clinical Biochemistry

3. Elevated levels of ketones (unmanaged diabetes mellitus), which bind bicarbonate in the
filtrate and prevent its conservation.

Disorders of the acid-base balance: ketoacidosis

Diabetic acidosis, or ketoacidosis, occurs most frequently in people with poorly controlled
diabetes mellitus. ketone bodies increase the acidity of the blood. Ketoacidosis can be severe
and, if not detected and treated properly, can lead to diabetic coma, which can be fatal.

Symptom of ketoacidosis:

• Deep, rapid breathing as the body attempts to drive off CO2 and compensate for the acidosis.
• Fruity-smelling breath, due to the exhalation of acetone.
• Dry skin and mouth, a flushed face, nausea, vomiting, and stomach pain.

Treatment for diabetic coma is ingestion or injection of sugar; its prevention is the proper daily
administration of insulin.

Blood Gas Test

• A blood gas test measures the amount of oxygen and carbon dioxide in the blood.
• It may also be used to determine the pH of the blood, or how acidic it is.
• The test is commonly known as a blood gas analysis or arterial blood gas (ABG) test.
• This can help your doctor determine how well your lungs and kidneys are working.

The test measures:

• Arterial blood pH (7.3-7.4) which indicates the amount of hydrogen ions in blood. A pH
of less than 7.0 is called acidic, and a pH greater than 7.0 is called alkaline. A lower blood
pH may indicate that your blood is more acidic and has higher carbon dioxide levels. A
higher blood pH may indicate that your blood is more alkaline and has a higher bicarbonate
level.

• Bicarbonate (22 to 28 milliequivalents per liter) which helps prevent the pH of blood from
becoming too acidic or too alkaline.

• Partial pressure of oxygen (75 to 100 mm Hg) which is a measure of the pressure of oxygen
dissolved in the blood. It determines how well oxygen can flow from the lungs into the
blood.