Diabetic Ketoacidosis

Diabetic ketoacidosis is a medical emergency (life-threatening disease for the patient), which occurs when metabolism is disrupted by cells using glucose as energy substrate (especially nerve cells, muscle cells and the liver). This complication occurs especially among people with diabetes, incorrectly or inadequately treated (which do not have enough insulin and manage such a high level of glucose). Normally, the body can not use glucose as energy substrate other than in the presence of sufficient amounts of insulin.
In case of a shortage of insulin, the body’s energy substrate catabolism is supplied by lipids (fats are another source of energy that do not require insulin for metabolism). Lipid catabolism occurs outside of the energy needed for the body and certain toxic metabolites (ketone bodies) that enter the circuit and trigger sangvin ketoacidosis (metabolic acidosis characterized by imbalance).


The cause of diabetic ketoacidosis is the large, persistent blood glucose (greater amount of glucose in the blood than normal). If ketoacidosis is not diagnosed in time and evolve, there can be some serious symptoms such as mental confusion, lethargy and even coma and unconsciousness with exitus (cetoacidizica coma death). Diabetic ketoacidosis is a medical life-threatening emergency. They occur most frequently among people with high insulin deficiency (mostly with type 1 diabetes), who may have very high blood sugar. Diabetic ketoacidosis can be caused by incorrect or insufficient administration of insulin, but can be precipitated by other factors such as intercurrent infections (eg respiratory virosis), some medical conditions, physical and emotional stress, severe dehydration or a combination of these factors.


Hyperglycemia (high blood sugar) can cause some symptoms such as:

-Hyperemia of skin (red skin)

-Hot, dry skin

-Visual disturbances (blurred vision)

-Marked fatigue (tiredness). Children with diabetes complicated with ketoacidosis may present as early symptoms loss of interest in usual activities, attention deficit disorders, apathy.

-Difficulty breathing (dyspnea), high-frequency breathing

-Cetoacidotica-halitosis (odor of breath, like acetone or nail polish, sometimes fruity odor, raw apple)

-Anorexia (loss of appetite), abdominal pain, nausea and vomiting


If ketoacidosis is not diagnosed and properly treated, symptoms may worsen, such as breathing becomes worse and Kussmaul breathing appears . there is cerebral edema (excess fluid buildup in the brain tissue) that leads to coma and sometimes death.

Complicated diabetic ketoacidosis is a medical emergency and must be treated in hospital, often in an intensive care unit. Treatment of diabetic ketoacidosis is to restore metabolic balance by administration of insulin and fluids parenterally (intravenous hydration). It is very important to monitor (control of blood electrolytes) and rebalance acidobazic (correction of metabolic acidosis). There are often required several days of treatment until normalization of biological parameters (normal blood glucose and correction of metabolic acidosis).

People who have an increased risk of developing diabetes are diabetic ketoacidosis (especially people with type 1 diabetes) who do not have a sufficient amount of insulin administered (either because forgetting to administer insulin or an insufficient amount administrated ). Diabetic ketoacidosis can be precipitated or triggered by other factors such as intercurrent infections, associated diseases, severe dehydration and stress (emotional or surgical).

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