Diabetic ketoacidosis history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
History
Age of onset
- Young children (age less than equal to 2 years) tend to present more likely with DKA as the first presentation of type 1 diabetes than older children.[1][2]
- Peripubertal and adolescent girls are affected more than other age groups.
Family History
- Families harboring HLA-associated high-risk genotypes are associated with a high chance of presenting DKA at diabetes onset.[3]
- Patients who have a family history of type 1 diabetes have less chance of developing DKA, possibly due to increased awareness of the disorder.[4]
Initial Presentation
- Patients may present with a history of poor compliance with insulin therapy or missed insulin injections due to vomiting or psychological reasons.
Past Medical History
- DKA is associated with a past medical history of type 1 diabetes.
- Type 2 diabetics may rarely develop DKA at a late stage of the disease due to faliure of beta pancreatic cells.
- History of infections (for example, urinary tract infections, pneumonia in an individual suffering from type 1 diabetes. [1]
Social History
- Patients may have a history of use of illicit drugs, for example, alcohol and cocaine.
- Patients may have poor socioeconomic status, which contributes to poor medication adherence in diabetics.
Symptoms
Early Symptoms
- Sluggish, extreme tiredness
- Fruity smell to breath/compare to nail polish remover, similar to peardrops
- Extreme thirst, despite large fluid intake
- Constant urination
- Extreme weight-loss
- Oral Thrush may be present, or/ yeast infections that fail to go away, this is because the normal fungal/flora present in oral cavity/cervix in women, the balance is upset and bacterial began to feast on the high sugar from urine output/ dry mouth from extreme thirst.
- Muscle wasting
- Agitation / Irritation / Aggression / Confusion
Late Symptoms
At this point, DKA is life-threatening and medical attention should be sought immediately.
- Emesis (vomiting), although this is not always a sign of late-stage ketoacidosis, and can occur both in early-stage ketoacidosis and in non-ketoacidic hyperglycaemia.
- Confusion
- Abdominal pain
- Loss of appetite
- Flu-like symptoms
- Lethargy and apathy
- Extreme weakness
- Kussmaul breathing ("air hunger"). Patients breathe more deeply and/or rapidly.
- Unconsciousness (diabetic coma) after prolonged DKA. At this stage, speedy medical attention is imperative.
References
- ↑ 1.0 1.1 de Vries L, Oren L, Lazar L, Lebenthal Y, Shalitin S, Phillip M (2013). "Factors associated with diabetic ketoacidosis at onset of Type 1 diabetes in children and adolescents". Diabet. Med. 30 (11): 1360–6. doi:10.1111/dme.12252. PMID 23758313.
- ↑ "Ketoacidosis at first presentation of type 1 diabetes mellitus among children: a study from Kuwait | Scientific Reports".
- ↑ Marigliano M, Morandi A, Maschio M, Costantini S, Contreas G, D'Annunzio G, Calcaterra V, Maffeis C (2013). "Diabetic ketoacidosis at diagnosis: role of family history and class II HLA genotypes". Eur. J. Endocrinol. 168 (1): 107–11. doi:10.1530/EJE-12-0541. PMID 23065995.
- ↑ Hekkala A, Ilonen J, Knip M, Veijola R (2011). "Family history of diabetes and distribution of class II HLA genotypes in children with newly diagnosed type 1 diabetes: effect on diabetic ketoacidosis". Eur. J. Endocrinol. 165 (5): 813–7. doi:10.1530/EJE-11-0376. PMID 21890652.