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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 ]
Ketoacidosis is a metabolic state caused by uncontrolled production of ketone bodies that cause a metabolic acidosis. While ketosis refers to any elevation of blood ketones , ketoacidosis is a specific pathologic condition that results in changes in blood pH and requires medical attention.
In the early days of insulin treatment for type 1 diabetes there was much debate as to whether strict control of hyperglycaemia would delay or prevent the long-term complications of diabetes. The work of Pirart [ 50 ] suggested that microvascular complications of diabetes were less likely to occur in individuals with better glycaemic control.
The treatment and recovery phases of diabetic ketoacidosis Volume resuscitation with 0.9% normal saline provides a chloride load, so that infusing more than 3–4L can cause acidosis Hyperalimentation ( i.e. , total parenteral nutrition )
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]
In certain situations the main cause is clear. For instance, a diabetic with ketoacidosis is a recognizable case where the main cause of acidemia is essentially obvious. [citation needed] The rate of cellular metabolic activity affects and, at the same time, is affected by the pH of the body fluids.
Ketosis is a metabolic state characterized by elevated levels of ketone bodies in the blood or urine. Physiological ketosis is a normal response to low glucose availability. . In physiological ketosis, ketones in the blood are elevated above baseline levels, but the body's acid–base homeostasis is maintain
Ketoacidosis may be the first symptom of immune-mediated diabetes, particularly in children and adolescents. Also, patients with immune-mediated diabetes can change from modest fasting hyperglycemia to severe hyperglycemia and even ketoacidosis as a result of stress or an infection. [16]