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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Spanish version
Diabetic Ketoacidosis
What is diabetic ketoacidosis?
Diabetic ketoacidosis is a serious, life-threatening
complication of high blood sugar. It must be treated
immediately. If you have ketoacidosis, you may go into a
diabetic coma.
How does it occur?
If you have diabetes and don't have proper treatment for it,
you may develop this very dangerous complication called
ketoacidosis. At first your blood sugar (glucose) level may
rise above normal. This condition is called hyperglycemia.
Hyperglycemia happens when you do not have enough insulin to
get sugar out of your blood and into your cells. When the
cells of the body can't use sugar for energy, they break
down fat for energy. The fat byproducts (ketones) and high
sugar level can cause ketoacidosis, a life-threatening
chemical imbalance.
Reasons why your blood sugar may increase, even if you are
taking insulin, include:
- not getting enough insulin
- not getting enough exercise
- eating the wrong amounts or types of food
- not testing your blood sugar levels properly or
regularly.
Also, ketoacidosis may result from changes in your life
such as illness, infection, trauma, heart attack, surgery,
pregnancy, or other types of stress.
If you have not yet been diagnosed with diabetes,
ketoacidosis may be the first sign that you have type 1
diabetes (insulin-dependent diabetes).
What are the symptoms?
Symptoms of hyperglycemia include:
- increased thirst
- increased hunger
- dry mouth
- increased urination.
If you have ketoacidosis you may also have these symptoms:
- excessive urination
- excessive thirstiness
- fruity-smelling breath
- nausea
- vomiting
- confusion
- tiredness.
The onset of a diabetic coma is usually gradual, producing
the symptoms of ketoacidosis first.
How is it diagnosed?
To diagnose ketoacidosis, your health care provider will ask
about your medical history, review your symptoms, and give
you a physical exam. Your provider will pay special
attention to:
- possible infection
- the amount of fluids in your body
- how clearly you are thinking
- breathing difficulty
- your heart and kidneys.
Your health care provider will do some tests to check the
levels of sugar and other chemicals in your blood. If
needed, your provider will also order other lab tests, a
chest x-ray, or ECG.
How is it treated?
- You will be given insulin as soon as ketoacidosis is
diagnosed.
- Your blood will be checked often for sugar levels and
chemical balances.
- You will be given fluids, possibly intravenously (IV).
- Your treatment will include antibiotic medication if you
have an infection.
How long will the effects last?
Ketoacidosis will continue until enough insulin is available
to the body to achieve a normal blood sugar level and
restore chemical balance. If this condition is not treated,
it can be fatal. With treatment, you may recover in hours
to days.
What can be done to help prevent diabetic ketoacidosis?
To help take care of yourself and prevent ketoacidosis,
follow these guidelines:
- Keep your blood sugar level under control.
- Eat a healthy diet.
- Follow the physical activity or exercise plan your health
care provider has recommended.
- Check your blood sugar level as often as you and your
health care provider have discussed.
- Test for ketones in your urine, if your blood sugar
level is high or you are ill or under more stress than
usual.
- Never take more insulin until you are sure that your
blood sugar level is too high. The symptoms of low blood
sugar can be similar to those of high blood sugar.
- Know the early signs and symptoms of ketoacidosis.
- Keep extra insulin with you.
- Teach a family member or friend how to give you an
injection if necessary.
- Wear a medical ID bracelet for diabetes.
Call your health care provider if your fasting blood sugar
is 240 mg/dl or more for 2 days, especially if you also have
vomiting or other symptoms of ketoacidosis.
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