Diabetic Ketoacidosis (DKA) is a dangerous, but, unfortunately, frequent complication in patients with type 1 diabetes. It can be quite difficult and without immediate treatment lead to coma and even death. It is the severity of this complication that necessitates raising the awareness of diabetic patients about DFA and its essence.
Diabetic ketoacidosis is a life-threatening condition caused by elevated acetone in the blood. It should be recognized that not all aware of the fact that such a ketone (acetone) of the body, so below we discuss their role during and diabetes.
- If the body lacks insulin, it cannot convert glucose into energy.
- Without natural energy, the body begins to decompose fats – an alternative source of energy.
- Ketone bodies are an acid that occurs when the body begins to burn its own fats.
- After the mechanism of formation of ketone bodies is launched, their number in the bloodstream is growing rapidly.
- Since in the absence of insulin, ketone bodies cannot enter the cell, they enter the urine through the kidneys.
- The presence of these by-products that poison the body can lead to serious complications.
Knowing the causes, signs and symptoms, as well as treatment methods, you can avoid the appearance of diabetic ketoacidosis .
For the first time, a German pathologist working in Manchester (United Kingdom) gave a lecture at the Royal College of Physicians in London at a lecture at the Royal College of Physicians in London in 1886. In his report, he referred to the results of several scientific papers by various researchers, some of which included experiments on measuring the level of ketones, acetoacetate and β- hydroxybutyrate in the blood of patients .
Prior to the discovery of insulin in the 1920s, attacks of DKA almost always resulted in a fatal outcome. By the 1930s, the death rate had dropped to 29 percent, and now it is 1-4%.
DKA attacks usually occur in patients with type 1 diabetes, but sometimes they also occur in patients with type 2 diabetes. The attack begins when the level of insulin in the blood falls, since in response the body switches to burning fatty acids for energy, which leads to an increase in the blood level of ketones. i
The relative frequency of attacks DKA varies in different countries of the world. For example, in the UK, only about 4% of patients with diabetes mellitus type 1 occur in the UK every year , and in Malaysia, more than 26% .
The attack of DKA is diagnosed by elevated blood sugar, low blood pH and elevated levels of ketones in the blood and urine. iv
The attack of DKA develops quickly, usually within 24 hours. At first, symptoms such as :
- Weakness and fatigue;
- Increased thirst;
- Dyspnea;
- Frequent urination;
- Fast or slow heartbeat;
Then they are added to :
- Breath with a fruity aroma (often with the smell of pear);
- Drop in blood pressure;
- Abdominal pain;
- Nausea and vomiting;
- Confusion
If you have noticed such symptoms in yourself , then immediately check your blood sugar level with a home appliance. If it exceeds 240 mg / dL (13.3 mmol / L), then check the ketone level using a blood or urine test kit.
If the level of ketones in your blood is:
- In the range of 6-1.5 mmol / l , then you are in a state with a slightly increased risk of developing an attack. Repeat the test after a couple of hours;
- In the range of 6-2.9 mmol / l , then you are in a state of moderate risk of developing an attack and should consult a doctor;
- Has reached or exceeded 3 mmol / l , then you have a very high risk of an attack of DKA, urgently contact the Ambulance.
If you tested for ketones not blood, but urine, then if the level of ketones in it:
- Slight (less than 2), then repeat the test within a few hours;
- Equal to 2 or more, the chances of an attack are high, then immediately consult a doctor or call an Ambulance.
In the case of a condition with a slightly increased or moderate risk of developing an attack of DKA, try yourself to get yourself out of this state by the following actions :
- Drink plenty of water to remove ketones from the body;
- Every 3-4 hours check blood sugar levels;
- Take insulin in accordance with the recommendations;
- Avoid physical exertion until glucose and ketone levels drop to normal .
The impetus for the development of an attack of DKA can serve as:
- Infectious disease (especially pneumonia or urinary tract infection), in which the level of insulin in the blood decreases;
- Insulin deficiency due to inadequate dosage, irregular intake or skipping the next dose;
- Alcohol or drug abuse;
- Decreased food intake, no matter what caused by: illness, starvation or intestinal upset;
- Medications such as corticosteroids and diuretics;
- Pregnancy;
- Heart attack vi .
In patients with type 2 diabetes, the likelihood of an attack of DKA is low, but the risk increases dramatically if:
- the patient has been ill for many years and his body does not produce insulin by itself;
- the patient belongs to a high-risk race, including Africans, Indians, Hispanics, and Hispanics vii .
So, the prevention of DKA attack is as follows:
- monitor blood sugar levels regularly;
- do not abuse alcohol;
- do not skip insulin techniques;
- eat regularly, varied and sufficient, do not starve;
- protect yourself from diseases, especially infectious;
- in case of illness of any disease, seek to recover as soon as possible, strictly following all the recommendations of the doctor;
- Do not use drugs that are not prescribed to you, especially corticosteroids and diuretics;
- keep your heart healthy by exercising and taking medication prescribed for you;
- when the first symptoms of an attack appear, measure the level of ketones in the blood and / or urine;
- if the risk of developing an attack is low, judging by the ketone test, then try to remove the symptoms yourself with abundant drinking, taking an extra dose of insulin and temporary refusal of physical activity;
- if despite the efforts you are making, the threat of seizures continues to hang over you, talk to your doctor about increasing your insulin dose.