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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] A person's breath may develop a specific "fruity" or acetone smell. [1]
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.
Metabolic acidosis is a serious electrolyte disorder characterized by an imbalance in the body's acid-base balance.Metabolic acidosis has three main root causes: increased acid production, loss of bicarbonate, and a reduced ability of the kidneys to excrete excess acids. [5]
Diabetic ketoacidosis (DKA), most typically seen in those with type 1 diabetes, is triggered by the build-up of chemicals called ketones. These are strongly acidic and a build-up can cause the blood to become acidic. [5] When these levels get too high it essentially poisons the body and causes DKA. [6]
The most common causes of high anion gap metabolic acidosis are: ketoacidosis, lactic acidosis, kidney failure, and toxic ingestions. [3]Ketoacidosis can occur as a complication of diabetes mellitus (diabetic ketoacidosis), but can occur due to other disorders, such as chronic alcoholism and malnutrition.
Ketogenesis pathway. The three ketone bodies (acetoacetate, acetone, and beta-hydroxy-butyrate) are marked within orange boxes. Ketogenesis is the biochemical process through which organisms produce ketone bodies by breaking down fatty acids and ketogenic amino acids.
Kussmaul breathing is a deep and labored breathing pattern often associated with severe metabolic acidosis, particularly diabetic ketoacidosis (DKA) but also kidney failure. It is a form of hyperventilation , which is any breathing pattern that reduces carbon dioxide in the blood due to increased rate or depth of respiration.
This image is a derivative work of the following images: File:Cell_membrane_detailed_diagram_en.svg licensed with PD-user . 2009-02-23T18:08:26Z Bibi Saint-Pol 877x361 (487132 Bytes) {{Information |Description= {{en|The cell membrane, also called the plasma membrane or plasmalemma, is a semipermeable lipid bilayer common to all living cells.