Diabetic ketoacidosis history and symptoms: Difference between revisions
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=== Age of onset === | === Age of onset === | ||
* Young children tend to present more likely with DKA as the first presentation of type 1 diabetes than older children.<ref name="pmid23758313">{{cite journal |vauthors=de Vries L, Oren L, Lazar L, Lebenthal Y, Shalitin S, Phillip M |title=Factors associated with diabetic ketoacidosis at onset of Type 1 diabetes in children and adolescents |journal=Diabet. Med. |volume=30 |issue=11 |pages=1360–6 |year=2013 |pmid=23758313 |doi=10.1111/dme.12252 |url=}}</ref> | * 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.<ref name="pmid23758313">{{cite journal |vauthors=de Vries L, Oren L, Lazar L, Lebenthal Y, Shalitin S, Phillip M |title=Factors associated with diabetic ketoacidosis at onset of Type 1 diabetes in children and adolescents |journal=Diabet. Med. |volume=30 |issue=11 |pages=1360–6 |year=2013 |pmid=23758313 |doi=10.1111/dme.12252 |url=}}</ref><ref name="urlKetoacidosis at first presentation of type 1 diabetes mellitus among children: a study from Kuwait | Scientific Reports">{{cite web |url=https://www.nature.com/articles/srep27519 |title=Ketoacidosis at first presentation of type 1 diabetes mellitus among children: a study from Kuwait | Scientific Reports |format= |work= |accessdate=}}</ref> | ||
* Peripubertal and adolescent girls are affected more than other age groups. | * Peripubertal and adolescent girls are affected more than other age groups. | ||
=== Family History === | === Family History === | ||
* Families harboring HLA-associated high-risk genotypes are associated with a high chance of presenting DKA at diabetes onset. | |||
* Patients who have a family history of type 1 diabetes have less chance of developing DKA due to increased awareness of the disorder. | |||
=== Initial Presentation === | === 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 === | === 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. | |||
=== Social History === | === Social History === | ||
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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.
- Patients who have a family history of type 1 diabetes have less chance of developing DKA due to increased awareness of the disorder.
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.
Social History
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
- ↑ 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".