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Diabetes Ketoacidosis: It’s symptoms, treatment and complications

Diabetes Ketoacidosis is a serious health complication and potentially life-threatening condition that affects people with diabetes. In most cases, it is those with type 1 diabetes that suffers from this. Only in very few cases, those who have type 2 diabetes been affected by diabetic ketoacidosis, but it is not as severe. The condition is usually the first sign of an undiagnosed type 1 condition. It can also happen to someone who has a previously diagnosed type 1 diabetes but underwent a trauma or an injury of some kind.

Causes of Ketoacidosis in Diabetes

When the body has low levels of insulin, it cannot metabolize the glucose in the body as it needs insulin to be transported to the cells. The liver keeps producing glucose and releasing it into the blood. This leads to high sugar levels which trigger the body to break down fats to release energy. This leads to an increased amount of ketones in the blood which are acidic. These create a chemical imbalance in the blood and affect the entire system. The condition is known as diabetic ketoacidosis.

Symptoms of Diabetes Ketoacidosis

Most signs and symptoms of diabetic ketoacidosis develop within 24 hours. You will find:
  1. Increased thirst
  2. Decreased alertness
  3. Excessive urination
  4. Dry skin and mouth
  5. Rapid, deep breathing
  6. Nausea and vomiting
  7. Excessive fatigue
  8. Breathlessness
  9. Headaches
  10. Flushed face
  11. Stomach ache
  12. Fruity-smelling breath
  13. Muscular aches
If your blood sugar is more than 240mg/dL, you should check your urine with a urine test strip. Also, if you exhibit any of the above symptoms, ask someone to test your ketones level. Try to reduce your glucose levels.It would be an emergency if you:
  1. Have been vomiting for more than a couple of hours.
  2. If your stomach hurts.
  3. If you feel confused and woozy.
  4. If you cannot breathe.
  5. If your sugar level is more than 300mg/dL consistently.

Risk Factors of Diabetes Ketoacidosis

There are certain risk factors for diabetic ketoacidosis.
  1. Illness
Sometimes having an infection or an illness triggers the body to produce certain other hormones. These can counteract the effect of insulin. Common infections that cause this are urinary tract infections and pneumonia.
  1. Issues with Insulin
If you are missing your insulin treatments or getting too little of it compared to what your situation demands, you could be susceptible to diabetic ketoacidosis.
  1. Heart attack
  2. Emotional trauma
  3. Alcohol
  4. Drug abuse
  5. Certain medications like diuretics or corticosteroids
  6. Have Type 1 diabetes

Treatment for Ketoacidosis

Diabetic Ketoacidosis is treated by giving insulin and electrolytes (to replace the ones lost through urination and vomiting) through injections or intravenously till your body attains the balance. Your doctor may evaluate your insulin dosage and recommend steps to prevent the situation from occurring again.

Complications of Diabetes Ketoacidosis

If you don’t treat Ketoacidosis, you could suffer from very serious complications.
  1. Hypoglycemia
When the treatment is administered to the patient with diabetic Ketoacidosis, he is given insulin as part of the treatment. This could lead to low glucose levels as insulin is injected into him.
  1. Hypokalemia
The electrolytes administered to treat diabetic Ketoacidosis can cause a drop in the potassium levels in the body. This can severely affect the heart and the nerves in the body.
  1. Cerebral Edema
When the brain tries to adjust to the quickly shifting sugar levels in the blood, it can cause swelling. This usually occurs in small kids with type 1 diabetes.
  1. Cardiac Arrest
  2. Kidney Failure
If left untreated, the situation can make the patient go into a coma and in some cases, even cause death.

Prevention of Diabetes Ketoacidosis

Good blood sugar control will help your body to maintain the chemical balance and thus, prevent diabetic Ketoacidosis. Preventing the condition is the best strategy. Here’s what you can do.
  1. Eat Healthily
The best way to avoid diabetic ketoacidosis is by eating healthy so that the glucose levels do not shoot up. Eat your meals on time and instead of three heavy meals, have six small meals. Fresh fruits and vegetables and whole grains should be an essential part of your diet.
  1. Stay Active
Another holistic way to keep your sugar levels in check is by exercising regularly. Even a half an hour of walk daily produces tremendous benefits. You could also try out yoga, swimming or aerobics to stay healthy.
  1. Manage Your Diabetes
Keep your blood glucose levels in check by eating healthy, staying active and taking your medication on time. It is surprising how many cases of diabetic ketoacidosis occur because the patient forgot or skipped taking their medication on time.
  1. Watch Your Sugar Levels
Monitor your glucose levels frequently every day and more so when you are ill or undergoing a stressful period.
  1. Make Adjustments to Your Insulin Dosage
Learn from your doctor how to evaluate and adjust your insulin dosage according to the changing demands of your body.
  1. Learn How to Check Ketone Levels
You could buy over-the-counter ketone urine test kits. Check your urine for ketones when you are under stress or are ill. Seek emergency medical care if your ketone levels are high. If the ketone levels come low, then increase your insulin dosage after consulting the doctor.
  1. Check Your Insulin  
Ensure that your insulin medication hasn’t crossed the expiry date. It should not be clumpy but should either be clear or have an even cloudy appearance. If you use a pump, check for leaks and the tube for air bubbles.
  1. Be Prepared
If the situation is beyond your control and if the high sugar levels are not reducing or the ketones are increasing in the urine, rush to the hospital. Have someone around you trained for such emergencies.

Takeaway

Diabetes can create serious complications. The best way to prevent diabetic Ketoacidosis is to control blood sugar levels. Take good care of yourself and follow your diabetes treatment plan efficiently. Take your anti-hyperglycemic medications on time and monitor your blood sugar levels frequently.Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.

Links and product recommendations in the information provided here are advertisements of third-party products available on the website. PharmEasy does not make any representation on the accuracy or suitability of such products/services. Advertisements do not influence the editorial decisions or content. The information in this blog is subject to change without notice. The authors and administrators reserve the right to modify, add, or remove content without notification. It is your responsibility to review this disclaimer regularly for any changes.

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Ketosis and Ketoacidosis: How Are They Different?

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Ketosis and ketoacidosis may be similar-sounding terms, but they are completely different conditions. While one helps to lose weight and extra fat in the body, the other is a life-threatening condition that can be controlled. Let us look at what both ‘Ketosis and Ketoacidosis’ mean.

What is Ketoacidosis?

The full term is known as Diabetic Ketoacidosis. It usually occurs in people with Type 1 diabetes. When the insulin levels drop too much, the blood sugar becomes very high. Since insulin is responsible for transporting the glucose molecules to the cells, they feel starved. To derive energy for biological processes, the body starts burning fat. This leads to the formation of ketones in the blood that is acidic. This causes a chemical imbalance in blood and is known as Diabetic Ketoacidosis. The condition can cause serious harm to various organs and shut down the human body.

Diabetic Ketoacidosis can be life-threatening if left untreated. The elevated acid levels in the body can result in loss of consciousness, going into a coma and even death. While it is primarily a condition that affects those with Type 1 diabetes, in rare cases it can affect those with Type 2 diabetes when their insulin levels fall really low.

The various causes of diabetic ketoacidosis are the inefficient management of diabetes or low levels of insulin. Injuries, illnesses, socially urinary tract infections, and pneumonia, emotional or physical trauma, drug abuse, excessive alcohol consumption, steroids medication and diuretics affect insulin levels tremendously. Those who have recently had a heart attack or a pancreatic infection are also vulnerable to diabetic ketoacidosis. The condition can develop in a short period, sometimes within 24 hours. Research says that diabetic ketoacidosis is the leading cause of death in people less than 24 years of age.

You can take some important steps to help prevent diabetic ketoacidosis which includes – Checking your blood sugar often, especially if you’re sick, keeping your blood sugar levels in your target range as much as possible, taking medicines as prescribed, even if you feel fine, consulting your doctor about how to adjust your insulin based on what you eat, how active you are, or if you’re sick.

Dr. Ashish Bajaj – M.B.B.S, M.D.

Symptoms of Diabetic ketoacidosis

Treatment of diabetic ketoacidosis usually involves the administration of insulin and electrolytes. Insulin helps to bring down the high glucose levels and electrolytes are given to replenish those that have been lost due to urination, vomiting and loss of appetite and to restore nerve, muscle and heart function.

Prevention of diabetic ketoacidosis is through good control of blood sugar levels. If the sugar levels are consistently higher than 300mg/dL, call an emergency. Keep urine test strips that check for ketone levels at home or with you if you will be away from home for a long time. If the tests show moderate to high levels of ketones, consult your doctor immediately. Drink plenty of fluids to flush out the toxins from the blood and take insulin medicines or injections to help your body.

The situation improves within 48 hours of being administered medical treatment. The doctor may review your insulin dosage to avoid further emergencies.

However, Ketoacidosis is not to be confused with ketosis. Ketosis and Ketoacidosis, while they may sound similar to the untrained mind, they are very different. Let’s learn how.

Also Read: Why Does My Poop Smell So Bad? Unpacking Digestive Health Concerns

What is Ketosis?

Ketosis is a natural biological state that the body enters into when burning fat as fuel in the absence of glucose. It happens in those who follow a low carbohydrate diet or those who have been fasting.   To burn fats instead of sugars is the aim of many low-carb diets that aim at weight reduction.

Those who follow a ketogenic diet undergo the process of ketosis. They limit their intake of carbohydrates and eat high fat and a moderate amount of protein in their diet. The protein aspect of the ketogenic diet is important since it stops the body from using up muscles (which are made of proteins) as a source of fuel. Forced to turn to fats, the body becomes leaner and fitter.

Ketones are the byproduct of fat-burning in the body. The liver burns off the fatty acids to provide fuel to the body and the ketones, thus formed, provide energy to the vital organs. A ketogenic diet helps to burn fat as the carb intake is much lesser. Plus it has more satiety levels. Research done on the ketogenic diet shows that it improves brain performance, reduces seizures in epileptic patients, benefits those with Parkinson’s and Alzheimer’s and enhances the performance of those who are involved in long stretches of exercise. The Ketogenic diet, when done under the supervision of experts, can help diabetics in executing good blood glucose control. It helps to boost the overall metabolic health of any individual.

There are some groups that must not follow the ketosis pattern of weight loss. Pregnant women, lactating mothers, people with kidney damage, and those who take certain medications must avoid ketosis happening in their bodies.

Diabetics who are on a weight loss journey will have some amount of ketones in their blood and urine. This is not a cause of worry as long as the blood sugar levels are kept within the permissible limits. The blood sugar levels must never cross 250mg/dL.

Ketosis and diabetic ketoacidosis are two conditions that are often confused with one another. While ketosis is a metabolic state the body goes into when it begins to burn stored fat for energy, diabetic ketoacidosis is a complication of diabetes (typically type 1 diabetes) which causes the body to produce excess blood acids.

Dr. M.G. Kartheeka, MBBS, MD

Ketosis and Ketoacidosis: Takeaway

Both the conditions, Ketosis and Ketoacidosis sound the same but are vastly different. If you plan to undergo a ketosis treatment voluntarily, talk to your doctor to rule out any possible negative outcomes. If you are a diabetic, continue taking insulin medicines even if you are ill or have suffered an injury. Take your medication on time to avoid complications. In case you feel you are suffering from diabetic ketoacidosis, call your doctor and head to the emergency section.

KetosisKetoacidosis
Helps the bodyHarms the body
Low levels of ketones in the bloodstreamHigh levels of ketones in the bloodstream
A natural process of the bodyBrought about by poor management of diabetes
SafeUnsafe
Occurs due to low quantities of carbohydrates in the dietOccurs due to low levels of insulin in the body
Can happen to anyoneAffects only those with diabetes
Doesn’t require medical treatmentNeeds immediate medical attention

Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.

Links and product recommendations in the information provided here are advertisements of third-party products available on the website. PharmEasy does not make any representation on the accuracy or suitability of such products/services. Advertisements do not influence the editorial decisions or content. The information in this blog is subject to change without notice. The authors and administrators reserve the right to modify, add, or remove content without notification. It is your responsibility to review this disclaimer regularly for any changes.