Diabetic Ketoacidodis : Causes Symptoms , Signs and Treatment

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