Diabetic Ketoacidosis - Medical Malpractice LawyersLEGAL HELPLINE: ☎ 855 804 7125
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Diabetic Ketoacidosis - Medical Malpractice
Diabetic ketoacidosis is a state of insulin deficiency and dehydration that is associated with elevated blood sugar and the elevation of bodily ketones. It is associated with diabetics who have type I diabetes primarily. It disturbs the body's chemistries and can result in death if untreated. Diabetic ketoacidosis is most common in those people under the age of 25 but can occur at any age. Males and females get the disease equally.
The main cause of diabetic ketoacidosis is the onset of dehydration. The body produces a stress response, releases hormones unopposed by a lack of insulin and fat, muscle and liver cells turn into glucose and fatty acids to use as fuel. The main hormones you will see include growth hormone, glucagon and epinephrine. The fatty acids turn into ketones by a process called oxidation so the body uses its own tissues to use for fuel.
The body shifts from using carbohydrates for fuel and turns into using fatty acids for fuel, just like in the fasting state. Blood pressure goes up and the kidneys cannot get rid of it fast enough. Urination is increased and the person becomes dehydrated. About ten percent of total bodily fluids are lost in this process and the person goes into diabetic ketoacidosis. Sodium and potassium are also lost due to the excessive urination.
It can be caused by an infection, especially diarrheal illnesses or vomiting illnesses, missing insulin doses, or newly diagnosed diabetes that has yet to be diagnosed. Other causes include having trauma, stroke, a heart attack, drug abuse, alcohol abuse and certain types of surgery. Up to ten percent have no known cause.
The main symptoms of diabetic ketoacidosis include having excessive thirst and fluid intake, generalized weakness, frequent urination, loss of appetite, vomiting, abdominal pain, confusion, shortness of breath, dry mouth, dry skin, increased heart rate, low blood pressure, increased breathing rate and a fruity order to the breath.
The main tests and exams for diabetic ketoacidosis include a history and physical exam which will be indicative of diabetic ketoacidosis. Blood tests will be done that will show an elevated blood sugar, alterations in potassium, sodium and other electrolytes. Ketones are elevated in the urine and the urinalysis can be abnormal. Blood gases are often formed and show a metabolic acidosis. Doctors also assess the cause of diabetic ketoacidosis using a chest x-ray, CT scans, urinalyses and ECG or electrocardiogram.
The treatment of diabetic ketoacidosis includes rapid fluid replacement and the administration of insulin by IV. These things cause a reversal of the dehydration and a lowering of the blood sugar. The blood acid level goes down and sugar and electrolytes are normalized. This must be done slowly and carefully or the person develops critical brain swelling. Patients are given IV potassium as this is depleted from the body in cases of diabetic ketoacidosis and is an important electrolyte to have. Insulin must be given right away as a continuous infusion so the blood sugar slowly stabilizes into more normal range. The blood sugar in ketoacidosis can be in the range of a thousand and needs to be less than 200 mg/dL. This stops the formation of ketones and the blood pH is made more normal. Potassium is driven into the cells where it needs to be. The person needs immediate admission to an intensive care unit because this is a serious condition.
If by some chance, the ketoacidosis is mild and the person can drink fluids, the IV fluids are forgone and the person drinks electrolyte-laced fluids to reverse dehydration and insulin is given subcutaneously. This is a rare situation as most people with ketoacidosis from diabetes have a severe case of the condition and need IV fluids and IV insulin.LEGAL HELPLINE: ☎ 855 804 7125
The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here