Diabetic Ketoacidosis

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Diabetic ketoacidosis (DKA) is an acute complication of diabetes mellitus. In DKA, the products of fat breakdown are converted to ketones which increases the acidity of blood.

Causes

Diabetic ketoacidosis may be caused by cessation of insulin therapy or physical and emotional stress, even when insulin therapy is continued. These events cause a relative decrease in insulin and increase in glucagon level. This change in the proportion of circulating insulin and glucagon causes breakdown of fats which are taken up by the liver.

The breakdown of fats increases the amount of fatty acids in the blood. The liver, induced by high glucagon and low insulin levels in the blood, converts the fatty acids to ketone bodies. The increased formation of ketone bodies increases the acidity of the blood. These sequence of events lead to diabetic ketoacidosis.

Symptoms of diabetic ketoacidosis

Diabetic ketoacidosis is felt as loss of appetite, nausea and vomiting, and increased amount of urine. Abdominal pain may also be present. Untreated, the patient may have decrease in level of consciousness and, eventually, become comatose.

The symptoms of DKA usually prompt the patient to seek medical consultation. This is in stark contrast to another complication of diabetes: diabetic coma.

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