What Is Diabetic Ketoacidosis and How Does It Affect the Body?
Diabetic ketoacidosis (DKA) is a serious and potentially life-threatening complication primarily associated with type 1 diabetes, although it can also occur in individuals with type 2 diabetes under certain conditions. It develops when the body lacks sufficient insulin to regulate blood sugar levels, leading to a cascade of metabolic imbalances that affect glucose, fat, and protein processing.
Understanding the Mechanism Behind DKA
When insulin levels are too low, cells cannot absorb glucose from the bloodstream for energy. As a result, the body begins breaking down fat at an accelerated rate. This process produces acidic substances known as ketones. As ketone levels build up in the blood, they cause the blood to become more acidic—a condition called metabolic acidosis.
This biochemical shift leads to several hallmark symptoms: extreme thirst, frequent urination, fatigue, nausea, and vomiting. In more advanced stages, patients may experience deep, labored breathing (known as Kussmaul respirations), mental confusion, and delayed reaction times. If left untreated, DKA can progress rapidly and lead to loss of consciousness, dangerously low blood pressure, and even organ failure.
Common Triggers of Diabetic Ketoacidosis
Infections—such as urinary tract infections, pneumonia, or other systemic illnesses—are among the most frequent causes of DKA. The stress response triggered by illness increases hormone levels like cortisol and adrenaline, which counteract insulin and elevate blood glucose.
Missed or inadequate insulin therapy is another major factor. Skipping insulin doses, using expired medication, or incorrect dosing can quickly disrupt metabolic balance in people dependent on insulin.
Physical or emotional stress, including trauma, surgery, heart attack, or severe psychological distress, can also provoke DKA by increasing insulin resistance and raising blood sugar levels.
How Is DKA Diagnosed?
Early diagnosis is crucial. Clinicians typically confirm DKA through laboratory tests showing significantly elevated blood glucose levels (often above 250 mg/dL), the presence of ketones in both blood and urine, and a lower-than-normal blood pH indicating acidosis.
Symptoms such as fruity-smelling breath (a sign of acetone buildup), rapid breathing, and altered mental status help support clinical suspicion. Prompt testing allows for timely intervention, which is essential to prevent complications.
Treatment and Prevention Strategies
Treatment involves intravenous fluids to correct dehydration, insulin therapy to lower blood sugar and stop ketone production, and electrolyte replacement—especially potassium—to restore normal cellular function.
Prevention plays a vital role. People with diabetes should monitor their blood sugar regularly, especially during illness. Using home ketone test strips when glucose levels are high can provide early warning signs. Staying hydrated, adhering strictly to prescribed insulin regimens, and seeking medical advice promptly when symptoms arise can significantly reduce the risk of DKA.
In summary, diabetic ketoacidosis is a medical emergency requiring immediate attention. With proper education, monitoring, and management, most cases can be prevented or successfully treated before reaching critical stages.