Severe and uncontrolled diabetes due to insulin deficiency
Characterized by
- High Blodd Glucose
- Ketone body and Acidosis
Treatment by Interavenous fluids and Insulin
Ketoacidosis is associated with Mortality 5-10 percent of total patients especially elderly
Precipitating Factors
1st introduction as Patient
Infections
Treatment errors
New Cases of Type 1
Mechanism or Pathophysiology
Insulin Defeciency leads to Catabolic Counter regulatory stress hormones as catecholamines , Cortisol , Glucagon and Growth hormone
All those hormones lead to hepatic overproduction of glucose and ketones with increasing lypolysis with the release of non esterified fatty acids
From adipose into Circulation
Fatty acids oxidized to the ketone bodies , acetoacetic acids and hydroxybutyric acid which
contribute to the acidosis and acetone which is volatile and smell
Ketoacidosid Symptoms
Polyuria
Thirst
Weight Loss
Weakness
Nausea
Leg Cramps
Drowsiness
Coma in 10% of cases
Ketoacidosis Signs
Dehydration
Hypotension
Tachycardia
Hyperventilation
Hypothermia
Bedside investigations
Blood Glucose Level
Test for Presence of Ketone bodies in Urine and Blood
Laboratory investigations
Blood Glucose
Na & K
Bicarbonate
Urea
Arterial Blood PH
Blood and Urine Cultures
