DIABETIC

KETOACIDOSIS
PRESENTED BY: AISHA, AROOJ AND
ABDULLAH
Table of contents

01 02 03
Introduction Causes Clinical Features

04 05 06
Risk Factors Diagnosis Treatment
 WHAT IS
DIABETIC
KETOACIDOSIS?
Introduction
“A life-threatening problem that affects people
with diabetes.”

It occurs when the body starts breaking down

fat at a rate that is much too fast.

The liver processes the fat into a fuel called

ketones, which causes the blood to become
acidic.
Causes of DKA
DKA happens when the signal from insulin in the body is so low that:

● Blood sugar (glucose) can't go into cells to be used as a fuel source.

● The liver makes a large amount of glucose.
● Fat is broken down too rapidly for the body to process.

DKA in Type 1 Diabetes:

● Often the first sign in undiagnosed individuals.

● Can be triggered by infection, injury, serious illness, missed insulin doses, or surgical stress in those already diagnosed.

DKA in Type 2 Diabetes:

● Less common and usually less severe.

● Triggered by prolonged uncontrolled blood sugar, missed medication doses, or severe illness or infection.
Causes of DKA
Trauma Cardiovascular Pancreatitis
Diseases
Physical or Emotional. Inflammation of the pancreas
Hearattack or Stroke. affecting insulin production.

Pregnncy Drug Misuse Medicines

Pregnancy related changes. Alcohol or drug misuse, Certain medicines such as
especially cocaine, elevating corticosteroids and some
DKA risk. diuretics.
Clinical Features
The main warning signs of DKA:

 Heavy breathing
 Fruity-smelling breath
 Confusion and irritability

Other symptoms of DKA to look out for:

 Excessive thirst (called polydipsia)

 Nausea and vomiting
 Abdominal pain
 Persistent need to urinate (polyuria)
 Blurred vision
 High blood-sugar levels
 Increased appetite (polyphasia)
 The 3 P’s
Polydispia Polyphasia

Polyuria
Risk Factors
The risk of diabetic ketoacidosis is highest if you:

 Have type 1 diabetes.

 Often miss insulin doses.

 Sometimes, diabetic ketoacidosis can occur with type 2 diabetes.

 In some cases, diabetic ketoacidosis may be the first sign of having diabetes.
Diagnosis of DKA

Physical Tests Blood Tests

 Physical Exam  Blood Sugar Level
 Urinalysis  Ketone Level
 Chest X-ray  Blood Acidity
 Electrocardiogram (ECG)  Blood Electrolyte Tests
Treatment of DKA
Hospitalization
● Treatment may occur in
the emergency room or
require hospital admission.
Fluids
● Replace fluids lost due to
excessive urination.
● Thin out the blood sugar.
● Administered orally or
intravenously (IV fluids).
Electrolyte Replacement Insulin Therapy
● Corrects imbalances of ● Reverses diabetic
essential minerals like ketoacidosis.
sodium, potassium, and
chloride. ● Administered
intravenously along with
● Maintains proper fluids and electrolytes.
functioning of the heart,
muscles, and nerve cells. ● Transition to regular
insulin therapy when blood
● Given intravenously. sugar levels drop to about
200 mg/dL (11.1 mmol/L)
and blood acidity
normalizes.
Overview
● Diabetic ketoacidosis is a serious complication of diabetes.

● The condition develops when the body can't produce enough insulin. Insulin plays a key role in helping sugar — a
major source of energy for muscles and other tissues — enter cells in the body.

● Without enough insulin, the body begins to break down fat as fuel.

● This causes a buildup of acids in the bloodstream called ketones.

● If it's left untreated, the buildup can lead to diabetic ketoacidosis.

● If you have diabetes or you're at risk of diabetes, learn the warning signs of diabetic ketoacidosis and when to seek
emergency care.
 WHAT IS
HYPERGLYCEMIC
HYPEROSMOLAR
SYNDROME?
Introduction
Diabetic hyperglycemic hyperosmolar
syndrome (HHS) is a complication of type 2
diabetes.

It involves an extremely high blood sugar

(glucose) level without the presence of
ketones.
Causes of HHS
HHS is a condition of:

● Extremely high blood sugar level

● Extreme lack of water (dehydration)
● Decreased alertness or consciousness (in many cases)
● A buildup of ketones in the body (ketoacidosis) may also occur.

 HHS is more often seen in people with type 2 diabetes who don't have their diabetes under control.

 It may also occur in those who have not been diagnosed with diabetes.

The condition may be brought on by:

● Infection
● Other illness, such as heart attack or stroke
● Medicines that decrease the effect of insulin in the body
● Medicines or conditions that increase fluid loss
● Running out of, or not taking prescribed diabetes medicines.
Risk Factors
Risk factors of HHS are:

● A stressful event such as infection, heart attack, stroke, or recent surgery

● Heart failure
● Impaired thirst
● Limited access to water (especially in people with dementia or who are bedbound)
● Older age
● Poor kidney function
● Poor management of diabetes, not following the treatment plan as directed
● Stopping or running out of insulin or other medicines that lower glucose level
Symptoms
Symptoms may include any of the following:

● Increased thirst and urination (at the beginning of the syndrome)

● Feeling weak
● Nausea
● Weight loss
● Dry mouth, dry tongue
● Fever
● Seizures
● Confusion
● Coma
Exams and Tests
Your health care provider will examine you and ask about your symptoms and medical history.
The exam may show that you have:

● Extreme dehydration
● Fever higher than 100.4°F (38°C)
● Increased heart rate
● Low systolic blood pressure

Tests that may be done include:

● Blood osmolarity (concentration)

● BUN and creatinine levels
● Blood sodium level (needs to be adjusted for the blood glucose level)
● Ketone test
● Blood glucose, potassium and bicarbonate
Treatment
● At the start of treatment, the goal is to correct the water loss.

● This will improve the blood pressure, urine output, and circulation.

● Blood sugar will also decrease.

● Fluids and potassium will be given through a vein (intravenously).

● This must be done carefully.

● A high glucose level may be treated with insulin given through a vein.
Possible Complications
Untreated, HHS may lead to any of the following:

● Shock
● Blood clot formation
● Brain swelling (cerebral edema)
● Increased blood acid level (lactic acidosis)
THANK YOU!