Page 279 - fourth year book

DIABETES MELLITUS

2. Diabetic ketoacidosis (DKA):

Diabetic ketoacidosis (DKA) is a serious condition that can lead to

diabetic coma or even death, This condition is a complex disordered metabolic
state characterized by hyperglycemia, ketoacidosis, and ketonuria.

When the cells don't get the glucose they need for energy, the body

begins to burn fat for energy, which produces ketones. The body does
this when it doesn’t have enough insulin to use glucose, the body’s

normal source of energy. When ketones build up in the blood, they make
it more acidic, and they are a warning sign that diabetes is out of control

or that the patient is getting sick.

 Causes of DKA :

1. Not enough insulin: the patient did not inject enough insulin. Or
the body could need more insulin than usual because of illness.

2. Not enough food: when the patient is sick, he often don't feel like
eating, sometimes resulting in high ketone levels. High levels may

also occur when he miss a meal.
3. Insulin reaction (low blood glucose): If testing shows high ketone

levels in the morning, the patient may have had an insulin reaction
while asleep.

 Warning Signs of DKA:

DKA usually develops slowly. But when vomiting occurs, this life-

threatening condition can develop in a few hours. Early symptoms

include the following:

 Thirst or a very dry mouth
 Frequent urination

 High blood glucose (blood sugar) levels
 High levels of ketones in the urine.

Then, other symptoms appear:

 Constantly feeling tired
 Dry or flushed skin

 Nausea, vomiting, or abdominal pain

248