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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 ]
Hypoglycemic diabetic coma: administration of the hormone glucagon to reverse the effects of insulin, or glucose given intravenously. Ketoacidotic diabetic coma: intravenous fluids, insulin and administration of potassium and sodium. Hyperosmolar diabetic coma: plenty of intravenous fluids, insulin, potassium and sodium given as soon as possible.
Diabetic coma is a medical emergency in which a person with diabetes mellitus is comatose (unconscious) because of one of the acute complications of diabetes: [24] [25] Severe diabetic hypoglycemia; Diabetic ketoacidosis advanced enough to result in unconsciousness from a combination of severe hyperglycemia, dehydration and shock, and exhaustion
Treatment depends on the underlying cause of the ketoacidosis. Diabetic ketoacidosis is resolved with insulin infusion, intravenous fluids, electrolyte replacement and supportive care. [1] Alcoholic ketoacidosis is treated with intravenous dextrose and supportive care and usually does not require insulin. [2]
This is an accepted version of this page This is the latest accepted revision, reviewed on 2 January 2025. Group of endocrine diseases characterized by high blood sugar levels This article is about the common insulin disorder. For the urine hyper-production disorder, see Diabetes insipidus. For other uses, see Diabetes (disambiguation). Medical condition Diabetes mellitus Universal blue circle ...
Ketoacidosis is most commonly caused by a deficiency of insulin in type 1 diabetes or late stage type 2 diabetes but can also be the result of chronic heavy alcohol use, salicylate poisoning, or isopropyl alcohol ingestion. [1] [2] Ketoacidosis causes significant metabolic derangements and is a life-threatening medical emergency. [2]
The major differential diagnosis is diabetic ketoacidosis (DKA). In contrast to DKA, serum glucose levels in HHS are extremely high, usually greater than 40-50 mmol/L (600 mg/dL). [6] Metabolic acidosis is absent or mild. [6] A temporary state of confusion (delirium) is also more common in HHS than DKA. HHS also tends to affect older people more.
The mainstay of physiologic ketotic hypoglycemia treatment typically includes management of the underlying cause, fluid resuscitation, and dietary supplementation of sugars and carbohydrates. [2] Alanine is a direct precursor in gluconeogenesis and can be used for treatment of ketotic hypoglycemia.
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