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The complications of diabetes can dramatically impair quality of life and cause long-lasting disability. Overall, complications are far less common and less severe in people with well-controlled blood sugar levels. [3] [4] [5] Some non-modifiable risk factors such as age at diabetes onset, type of diabetes, gender, and genetics may influence risk.
Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. [1] Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion and occasionally loss of consciousness. [1]
If the patient is known to have diabetes, the diagnosis of diabetic ketoacidosis is usually suspected from the appearance and a history of 1–2 days of vomiting. The diagnosis is confirmed when the usual blood chemistries in the emergency department reveal a high blood sugar level and severe metabolic acidosis .
The most common cause of ketoacidosis is a deficiency of insulin in type 1 diabetes or late-stage type 2 diabetes. This is called diabetic ketoacidosis and is characterized by hyperglycemia, dehydration and metabolic acidosis. Other electrolyte disturbances such as hyperkalemia and hyponatremia may also be present.
A more common cause is excessive loss of potassium, often associated with heavy fluid losses that flush potassium out of the body. Typically, this is a consequence of diarrhea, excessive perspiration, losses associated with crush injury, or surgical procedures. Vomiting can also cause hypokalemia, although not much potassium is lost from the ...
Common symptoms of ketosis are anorexia, abdominal discomfort, and nausea, sometimes progressing to vomiting. [7] However, the diagnosis of ketotic hypoglycemia poses a challenge to clinicians, given how nonspecific symptoms can be and given that children in this age range are typically unable to describe their symptoms. [2]
[citation needed] A list of common causes: Prolonged fasting Diarrheal illness in young children, especially rotavirus gastroenteritis; Idiopathic ketotic hypoglycemia; Isolated growth hormone deficiency, hypopituitarism; Insulin excess. Hyperinsulinism due to several congenital disorders of insulin secretion; Insulin injected for type 1 diabetes
The leading cause of hyperglycemia in type 2 diabetes is the failure of insulin to suppress glucose production by glycolysis and gluconeogenesis due to insulin resistance. [39] Insulin normally inhibits glycogenolysis, but fails to do so in a condition of insulin resistance, resulting in increased glucose production. [ 40 ]