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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]]''' | ||
{{ | |||
{{Diabetic ketoacidosis (patient information)}} | |||
{{CMG}}; '''Associate Editor(s)-In-Chief:''' Jinhui Wu, M.D.; '''Assistant Editor-In-Chief:'''Laura Linnemeier | {{CMG}}; '''Associate Editor(s)-In-Chief:''' Jinhui Wu, M.D.; '''Assistant Editor-In-Chief:'''Laura Linnemeier | ||
==Overview== | ==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, | Diabetic ketoacidosis is a serious complication of [[diabetes]]. It may occur in both [[type 1 diabetes]] and [[Diabetes mellitus type 2|type 2 diabetes]], but is most common in people with [[Diabetes mellitus type 1|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|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, [[urine]] [[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 [[fluid]] loss through excessive [[urination]] and [[vomiting]]. [[Prognosis]] of diabetic ketoacidosis varies, depending on patient's age, treatment and [[complication]]s. | ||
==What are the symptoms of | ==What are the symptoms of Diabetic ketoacidosis?== | ||
The following signs and symptoms | The following signs and symptoms are indicative 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]] | ||
| Line 21: | Line 24: | ||
*[[Weakness]] or [[fatigue]] | *[[Weakness]] or [[fatigue]] | ||
*[[Confusion]], [[stupor]] that may progress to [[coma]] | *[[Confusion]], [[stupor]] that may progress to [[coma]] | ||
==Diseases with similar symptoms== | |||
*Severe [[diabetic hypoglycemia]] | |||
*[[Hyperosmolar nonketotic coma]] | |||
*[[Acute pancreatitis]] | |||
==What causes Diabetic ketoacidosis?== | |||
Sugar which is the main source of energy for [[Cell (biology)|cells]], needs [[insulin]] to enter inside the [[Cell (biology)|cells]]. When the patient lacks enough [[insulin]], sugar will not be able to enter inside the [[Cell (biology)|cell]]. This situation prompts the release of certain [[hormones]] that break down [[fat]]. The breakdown of [[fat]] produces [[ketone bodies]]. This process may be triggered in the presence of any [[infection]], illness or drugs. | |||
==Who is at highest risk?== | ==Who is at highest risk?== | ||
*For patients with [[type 1 diabetes]], stresses such as [[infection]], [[trauma]], [[heart attack]],[[surgery]] or missing | *For patients with [[type 1 diabetes]], stresses such as [[infection]], [[trauma]], [[heart attack]],[[surgery]] or missing [[insulin]] doses can lead to diabetic ketoacidosis. | ||
* | *Patients with [[Diabetes mellitus type 2|type 2 diabetes]] who suffer a severe illness are at risk for diabetic ketoacidosis. | ||
==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 ketoacidosis 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]] | ||
==Diagnosis== | |||
*Patients with a medical history of [[diabetes]], during an illness such as [[pneumonia]], [[heart attack]], [[stroke]] or [[pregnancy]]. [[Blood sugar]] level higher than 250 mg/dl. | |||
*High [[blood]] [[ketone]] levels. | |||
*[[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 the [[urine]] of patients with diabetic ketoacidosis. Additional tests such as a [[Chest X-ray|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. | |||
==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 electrolytes|Fluid and electrolyte]] replacement: The patients will receive [[fluids]] and [[Electrolyte|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 | *[[Insulin]] therapy: The purpose of [[insulin]] therapy is to control [[blood]] [[sugar]] levels. 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 | *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 disease. | ||
====Medications to avoid==== | |||
{{MedCondContrPI | |||
= | |MedCond = diabetic ketoacidosis|Glipizide|Glyburide|Glyburide and Metformin|Linagliptin and Metformin hydrochloride|Repaglinide|Saxagliptin hydrochloride and Metformin hydrochloride}} | ||
==Where to find medical care for | ==Where to find medical care for Diabetic ketoacidosis?== | ||
[http://maps.google.com/maps?f=q&hl=en&geocode=&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|diabetic ketoacidosis}}}}&sll=37.0625,-95.677068&sspn=65.008093,112.148438&ie=UTF8&ll=37.0625,-95.677068&spn=91.690419,149.414063&z=2&source=embed Directions to Hospitals Treating diabetic ketoacidosis] | [http://maps.google.com/maps?f=q&hl=en&geocode=&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|diabetic ketoacidosis}}}}&sll=37.0625,-95.677068&sspn=65.008093,112.148438&ie=UTF8&ll=37.0625,-95.677068&spn=91.690419,149.414063&z=2&source=embed Directions to Hospitals Treating diabetic ketoacidosis] | ||
==What to expect (Outook/Prognosis)?== | ==What to expect (Outook/Prognosis)?== | ||
| Line 63: | Line 70: | ||
*Whether [[complication]]s, such as [[heart attack]], [[renal failure]] and [[hypokalemia]] occur. | *Whether [[complication]]s, such as [[heart attack]], [[renal failure]] and [[hypokalemia]] occur. | ||
== | ==Possible complication== | ||
Diabetic Ketoacidosis is a [[fatal]] condition if not treated promptly. | |||
==Prevention== | |||
*Making a healthy lifestyle: Make healthy eating and physical activity part of your daily routine. Take [[Mouth|oral]] [[diabetes]] medications or [[insulin]] under your doctor's direction. | |||
*Learning to self-monitor 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|signs and symptoms]] of ketoacidosis: When people in the conditions of [[stress]] such as [[infection]]s, [[stroke]], [[pregnancy]] or [[surgery]], 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. | |||
==Sources== | |||
http://www.nlm.nih.gov/medlineplus/ency/article/000320.htm | http://www.nlm.nih.gov/medlineplus/ency/article/000320.htm | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Patient information]] | [[Category:Patient information]] | ||
[[Category:Disease]] | |||
[[Category:Disease | |||
[[Category:Medicine]] | [[Category:Medicine]] | ||
[[Category:Pediatrics]] | [[Category:Pediatrics]] | ||
[[Category:Endocrinology]] | [[Category:Endocrinology]] | ||
[[Category:Mature chapter]] | [[Category:Mature chapter]] | ||
[[Category:Diabetes]] | [[Category:Diabetes]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category: | [[Category:Intensive care medicine]] | ||
Latest revision as of 21:07, 7 September 2017
For the WikiDoc page for this topic, click here
|
Diabetic ketoacidosis |
|
Diabetic ketoacidosis On the Web |
|---|
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Jinhui Wu, M.D.; Assistant Editor-In-Chief:Laura Linnemeier
Overview
Diabetic ketoacidosis is a serious complication of diabetes. It may occur in both type 1 diabetes and type 2 diabetes, but is 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, urine 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 fluid loss through excessive urination and vomiting. Prognosis of diabetic ketoacidosis varies, depending on patient's age, treatment and complications.
What are the symptoms of Diabetic ketoacidosis?
The following signs and symptoms are indicative of diabetic ketoacidosis:
- Shortness of breath
- Fruity breath
- Nausea and vomiting
- Excessive thirst
- Dry skin and mouth
- Flushed face
- Frequent urination
- Stomach pain
- Fatigue
- Loss of appetite
- Weakness or fatigue
- Confusion, stupor that may progress to coma
Diseases with similar symptoms
What causes Diabetic ketoacidosis?
Sugar which is the main source of energy for cells, needs insulin to enter inside the cells. When the patient lacks enough insulin, sugar will not be able to enter inside the cell. This situation prompts the release of certain hormones that break down fat. The breakdown of fat produces ketone bodies. This process may be triggered in the presence of any infection, illness or drugs.
Who is at highest risk?
- For patients with type 1 diabetes, stresses such as infection, trauma, heart attack,surgery or missing insulin doses can lead to diabetic ketoacidosis.
- Patients with type 2 diabetes who suffer a severe illness are at risk for diabetic ketoacidosis.
When to seek urgent medical care?
Call your health care provider if symptoms of diabetic ketoacidosis develop. If you experience either of the following symptoms, seeking urgent medical care as soon as possible:
- Vomiting or nausea
- Shortness of breath or fruity breath
- Decreased consciousness or mental stupor
Diagnosis
- Patients with a medical history of diabetes, during an illness such as pneumonia, heart attack, stroke or pregnancy. Blood sugar level higher than 250 mg/dl.
- High blood ketone levels.
- 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 the urine 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.
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 levels. 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 disease.
Medications to avoid
Patients diagnosed with diabetic ketoacidosis should avoid using the following medications:
- Glipizide
- Glyburide
- Glyburide and Metformin
- Linagliptin and Metformin hydrochloride
- Repaglinide
- Saxagliptin hydrochloride and Metformin hydrochloride
If you have been diagnosed with diabetic ketoacidosis, consult your physician before starting or stopping any of these medications.
Where to find medical care for Diabetic ketoacidosis?
Directions to Hospitals Treating diabetic ketoacidosis
What to expect (Outook/Prognosis)?
Prognosis of diabetic ketoacidosis depends on:
- Whether the patient is diagnised or treated in time
- The age of the patient: Older people have worse outcomes than the young.
- Whether complications, such as heart attack, renal failure and hypokalemia occur.
Possible complication
Diabetic Ketoacidosis is a fatal condition if not treated promptly.
Prevention
- 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-monitor 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, pregnancy or surgery, 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.
Sources
http://www.nlm.nih.gov/medlineplus/ency/article/000320.htm Template:WH Template:WS