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'''For the WikiDoc page for this topic, click [[Diabetic ketoacidosis|here]]'''
'''For the WikiDoc page for this topic, click [[Diabetic ketoacidosis|here]]'''
{{SI}}
{{SI}}


{{CMG}};  Jinhui Wu, MD
{{CMG}};  '''Associate Editor(s)-In-Chief:''' Jinhui Wu, M.D.; Laura Linnemeier


{{EJ}}
==Overview==
 
==What is diabetic ketoacidosis?==
Diabetic ketoacidosis is a serious complication of diabetes. It may occur in both [[type 1 diabetes]] and type 2, but most common in people with type 1 diabetes. Some triggers, such as [[infection]], [[trauma]], [[heart attack]], [[surgery]] or missing doses of insulin may lead to this condition. Usual signs and symptoms of diabetic ketoacidosis include [[shortness of breath]], fruity breath, [[nausea]] and [[vomiting]], excessive [[thirst]], even [[confusion]], [[stupor]] that may progress to [[coma]]. Tests of [[blood sugar]] level, urin [[ketone]] level and [[arterial blood gas]] may be helpful for the diagnosis. The goal of treatment of diabetic ketoacidosis is to correct the high [[glucose]] level by giving more [[insulin]] and to replace fluids lost through excessive urination and [[vomiting]]. Prognosis of diabetic ketoacidosis varies, depending on patients' age, treatment and [[complication]]s.
Diabetic ketoacidosis is a serious complication of diabetes. It may occur in both [[type 1 diabetes]] and type 2, but most common in people with type 1 diabetes. Some triggers, such as [[infection]], [[trauma]], [[heart attack]], [[surgery]] or missing doses of insulin may lead to this condition. Usual signs and symptoms of diabetic ketoacidosis include [[shortness of breath]], fruity breath, [[nausea]] and [[vomiting]], excessive [[thirst]], even [[confusion]], [[stupor]] that may progress to [[coma]]. Tests of [[blood sugar]] level, urin [[ketone]] level and [[arterial blood gas]] may be helpful for the diagnosis. The goal of treatment of diabetic ketoacidosis is to correct the high [[glucose]] level by giving more [[insulin]] and to replace fluids lost through excessive urination and [[vomiting]]. Prognosis of diabetic ketoacidosis varies, depending on patients' age, treatment and [[complication]]s.


==How do I know if I have diabetic ketoacidosis and what are the symptoms of diabetic ketoacidosis?==
==How do I know if I have diabetic ketoacidosis and what are the symptoms of diabetic ketoacidosis?==
The following signs and symptoms warn you the possibility of diabetic ketoacidosis:  
The following signs and symptoms warn you the possibility of diabetic ketoacidosis:  
 
*[[Shortness of breath]]
:*[[Shortness of breath]]
*Fruity breath
:*Fruity breath
*[[Nausea]] and [[vomiting]]
:*[[Nausea]] and [[vomiting]]
*Excessive [[thirst]]
:*Excessive [[thirst]]
*Dry skin and mouth
:*Dry skin and mouth
*Flushed face
:*Flushed face
*[[Frequent urination]]
:*[[Frequent urination]]
*[[Stomach pain]]
:*[[Stomach pain]]
*[[Fatigue]]
:*[[Fatigue]]
*[[Loss of appetite]]
:*[[Loss of appetite]]
*[[Weakness]] or [[fatigue]]
:*[[Weakness]] or [[fatigue]]
*[[Confusion]], [[stupor]] that may progress to [[coma]]
:*[[Confusion]], [[stupor]] that may progress to [[coma]]


==Who is at risk for diabetic ketoacidosis?==
==Who is at risk for diabetic ketoacidosis?==
:*For patients with [[type 1 diabetes]], stresses such as [[infection]], [[trauma]], [[heart attack]],[[surgery]] or missing doses of [[insulin]], can lead to diabetic ketoacidosis.
*For patients with [[type 1 diabetes]], stresses such as [[infection]], [[trauma]], [[heart attack]],[[surgery]] or missing doses of [[insulin]], can lead to diabetic ketoacidosis.
 
*People with type 2 diabetes, not usually as type 1, may lead to diabetic ketoacidosis as a complication by a severe illness.
:*People with type 2 diabetes, not usually as type 1, may lead to diabetic ketoacidosis as a complication by a severe illness.


==How to know you have diabetic ketoacidosis?==
==How to know you have diabetic ketoacidosis?==
:*The patient with medical history of [[diabetes]], during an illness such as [[pneumonia]], [[heart attack]], [[stroke]] or [[pregnancy]].
*The patient with medical history of [[diabetes]], during an illness such as [[pneumonia]], [[heart attack]], [[stroke]] or [[pregnancy]].*[[Blood sugar]] level  higher than 240 mg/dl.  
:*[[Blood sugar]] level  higher than 240 mg/dl.  
*Higer blood ketone level
:*Higer blood ketone level
*Arterial blood gas: When diabetic ketoacidosis occurs, the blood will become acidic (acidosis). This can damage organs throughout the body.
:*Arterial blood gas: When diabetic ketoacidosis occurs, the blood will become acidic (acidosis). This can damage organs throughout the body.
*Urinalysis:[[Sugar]] and [[ketone]] can be checked in urin of patients with diabetic ketoacidosis.*Additional tests, such as a chest x-ray or a [[electrocardiogram]], may be needed to help the doctor determine what triggered the episode of diabetic ketoacidosis or what damage the ketoacidosis may have caused.
:*Urinalysis:[[Sugar]] and [[ketone]] can be checked in urin of patients with diabetic ketoacidosis.
:*Additional tests, such as a chest x-ray or a [[electrocardiogram]], may be needed to help the doctor determine what triggered the episode of diabetic ketoacidosis or what damage the ketoacidosis may have caused.


==When to seek urgent medical care?==
==When to seek urgent medical care?==
Call your health care provider if symptoms of diabetic develop. If you experience either of the following symptoms, seeking urgent medical care as soon as possible:  
Call your health care provider if symptoms of diabetic develop. If you experience either of the following symptoms, seeking urgent medical care as soon as possible:  
 
*[[Vomiting]] or [[nausea]]
:*[[Vomiting]] or [[nausea]]
*[[Shortness of breath]] or fruity breath   
:*[[Shortness of breath]] or fruity breath   
*Decreased [[consciousness]] or mental [[stupor]]
:*Decreased [[consciousness]] or mental [[stupor]]


==Treatment options==
==Treatment options==
The goal of treatment of diabetic ketoacidosis is to correct the high blood glucose level by giving more insulin and to replace fluids lost through excessive urination and [[vomiting]].  
The goal of treatment of diabetic ketoacidosis is to correct the high blood glucose level by giving more insulin and to replace fluids lost through excessive urination and [[vomiting]].  
 
*Fluid and electrolyte replacement: The patients will receive fluids and electrolytes to replace those that they lost through excessive urination and [[vomiting]]. This can help dilute the excess sugar and help keep a normal internal environment to make the body work well.   
:*Fluid and electrolyte replacement: The patients will receive fluids and electrolytes to replace those that they lost through excessive urination and [[vomiting]]. This can help dilute the excess sugar and help keep a normal internal environment to make the body work well.   
*Insulin therapy: The purpose of insulin therapy is to control blood sugar under a nomal scope. Usually, the patients with diabetic ketoacidosis will receive insulin therapy through a vein.
:*Insulin therapy: The purpose of insulin therapy is to control blood sugar under a nomal scope. Usually, the patients with diabetic ketoacidosis will receive insulin therapy through a vein.
*Treatment for the trigger of diabetic ketoacidosis: When the patient returns to normal, the doctor will consider what may have triggered the episode of diabetic ketoacidosis and make treatment protocol for the diseases.
:*Treatment for the trigger of diabetic ketoacidosis: When the patient returns to normal, the doctor will consider what may have triggered the episode of diabetic ketoacidosis and make treatment protocol for the diseases.


==Diseases with similar symptoms==
==Diseases with similar symptoms==
:*Severe [[diabetic hypoglycemia]]
*Severe [[diabetic hypoglycemia]]
:*[[Hyperosmolar nonketotic coma]]
*[[Hyperosmolar nonketotic coma]]
:*[[Acute pancreatitis]]
*[[Acute pancreatitis]]


==Where to find medical care for diabetic ketoacidosis?==
==Where to find medical care for diabetic ketoacidosis?==
Line 62: Line 53:


==Prevention of diabetic ketoacidosis==
==Prevention of diabetic ketoacidosis==
:*Making a healthy lifestyle: Make healthy eating and physical activity part of your daily routine. Take oral diabetes medications or [[insulin]] under your doctor's direction.
*Making a healthy lifestyle: Make healthy eating and physical activity part of your daily routine. Take oral diabetes medications or [[insulin]] under your doctor's direction.
:*Learning to self-moniting of your [[blood sugar]] level: You may need to learn to check and record your blood sugar level at least several times a day. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range.
*Learning to self-moniting of your [[blood sugar]] level: You may need to learn to check and record your blood sugar level at least several times a day. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range.
:*Warning signs and symptoms of ketoacidosis: When people in the conditions of [[stress]] such as [[infection]]s, [[stroke]], [[pranancy]] or [[sutgery]], measuring urine [[ketone]]s may give more information than [[glucose]] measurements alone. If you suspect that you have diabetic ketoacidosis, seek emergency care as soon as possible.
*Warning signs and symptoms of ketoacidosis: When people in the conditions of [[stress]] such as [[infection]]s, [[stroke]], [[pranancy]] or [[sutgery]], measuring urine [[ketone]]s may give more information than [[glucose]] measurements alone. If you suspect that you have diabetic ketoacidosis, seek emergency care as soon as possible.


==What to expect (Outook/Prognosis)?==
==What to expect (Outook/Prognosis)?==
Prognosis of diabetic ketoacidosis depends on:
Prognosis of diabetic ketoacidosis depends on:
 
*Whether the patient is diagnised or treated in time
:*Whether the patient is diagnised or treated in time
*The age of the patient: Older people have worse outcomes than the young.  
:*The age of the patient: Older people have worse outcomes than the young.  
*Whether [[complication]]s, such as [[heart attack]], [[renal failure]] and [[hypokalemia]] occur.
:*Whether [[complication]]s, such as [[heart attack]], [[renal failure]] and [[hypokalemia]] occur.


==Copyleft Sources==
==Copyleft Sources==
http://www.mayoclinic.com/print/diabetic-ketoacidosis/DS00674/DSECTION=all&METHOD=print
http://www.mayoclinic.com/print/diabetic-ketoacidosis/DS00674/DSECTION=all&METHOD=print
http://www.nlm.nih.gov/medlineplus/ency/article/000320.htm
http://www.nlm.nih.gov/medlineplus/ency/article/000320.htm


{{WH}}
[[Category:Patient Information]]
[[Category:Medical emergencies]]
[[Category:Disease state]]
[[Category:Medicine]]
[[Category:Pediatrics]]
[[Category:Autoimmune diseases]]
[[Category:Endocrinology]]
[[Category:Mature chapter]]
[[Category:Nephrology]]
[[Category:Diabetes]]
[[Category:Endocrinology patient information]]
{{WH}}  
{{WS}}
{{WS}}
[[Category:Patient Information]]

Revision as of 22:32, 28 July 2011

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Jinhui Wu, M.D.; Laura Linnemeier

Overview

Diabetic ketoacidosis is a serious complication of diabetes. It may occur in both type 1 diabetes and type 2, but most common in people with type 1 diabetes. Some triggers, such as infection, trauma, heart attack, surgery or missing doses of insulin may lead to this condition. Usual signs and symptoms of diabetic ketoacidosis include shortness of breath, fruity breath, nausea and vomiting, excessive thirst, even confusion, stupor that may progress to coma. Tests of blood sugar level, urin ketone level and arterial blood gas may be helpful for the diagnosis. The goal of treatment of diabetic ketoacidosis is to correct the high glucose level by giving more insulin and to replace fluids lost through excessive urination and vomiting. Prognosis of diabetic ketoacidosis varies, depending on patients' age, treatment and complications.

How do I know if I have diabetic ketoacidosis and what are the symptoms of diabetic ketoacidosis?

The following signs and symptoms warn you the possibility of diabetic ketoacidosis:

Who is at risk for diabetic ketoacidosis?

  • For patients with type 1 diabetes, stresses such as infection, trauma, heart attack,surgery or missing doses of insulin, can lead to diabetic ketoacidosis.
  • People with type 2 diabetes, not usually as type 1, may lead to diabetic ketoacidosis as a complication by a severe illness.

How to know you have diabetic ketoacidosis?

  • The patient with medical history of diabetes, during an illness such as pneumonia, heart attack, stroke or pregnancy.*Blood sugar level higher than 240 mg/dl.
  • Higer blood ketone level
  • Arterial blood gas: When diabetic ketoacidosis occurs, the blood will become acidic (acidosis). This can damage organs throughout the body.
  • Urinalysis:Sugar and ketone can be checked in urin of patients with diabetic ketoacidosis.*Additional tests, such as a chest x-ray or a electrocardiogram, may be needed to help the doctor determine what triggered the episode of diabetic ketoacidosis or what damage the ketoacidosis may have caused.

When to seek urgent medical care?

Call your health care provider if symptoms of diabetic develop. If you experience either of the following symptoms, seeking urgent medical care as soon as possible:

Treatment options

The goal of treatment of diabetic ketoacidosis is to correct the high blood glucose level by giving more insulin and to replace fluids lost through excessive urination and vomiting.

  • Fluid and electrolyte replacement: The patients will receive fluids and electrolytes to replace those that they lost through excessive urination and vomiting. This can help dilute the excess sugar and help keep a normal internal environment to make the body work well.
  • Insulin therapy: The purpose of insulin therapy is to control blood sugar under a nomal scope. Usually, the patients with diabetic ketoacidosis will receive insulin therapy through a vein.
  • Treatment for the trigger of diabetic ketoacidosis: When the patient returns to normal, the doctor will consider what may have triggered the episode of diabetic ketoacidosis and make treatment protocol for the diseases.

Diseases with similar symptoms

Where to find medical care for diabetic ketoacidosis?

Directions to Hospitals Treating diabetic ketoacidosis

Prevention of diabetic ketoacidosis

  • Making a healthy lifestyle: Make healthy eating and physical activity part of your daily routine. Take oral diabetes medications or insulin under your doctor's direction.
  • Learning to self-moniting of your blood sugar level: You may need to learn to check and record your blood sugar level at least several times a day. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range.
  • Warning signs and symptoms of ketoacidosis: When people in the conditions of stress such as infections, stroke, pranancy or sutgery, measuring urine ketones may give more information than glucose measurements alone. If you suspect that you have diabetic ketoacidosis, seek emergency care as soon as possible.

What to expect (Outook/Prognosis)?

Prognosis of diabetic ketoacidosis depends on:

Copyleft Sources

http://www.mayoclinic.com/print/diabetic-ketoacidosis/DS00674/DSECTION=all&METHOD=print http://www.nlm.nih.gov/medlineplus/ency/article/000320.htm Template:WH Template:WS