Patient Education
What is Diabetic Ketoacidosis?
To break it down, it's a condition that can occur in diabetic patients in which there is an excess of ketones and the body is in a highly acidic state. When the body is unable to use the extra glucose due to a lack of insulin, fat is broken down, resulting in ketones. These ketone bodies are then found in the blood, causing it to become more acidic. If left untreated, this can lead to life-threatening complications.
Why does DKA occur?
When there is excess sugar in the blood and decreased levels of insulin. Some causes are -
Missed or decreased dose of insulin
Interrupted insulin delivery if using an insulin pump
Infection or injury
Stress factors
What are the symptoms and signs of DKA?
Symptoms occur due to hyperglycaemia –
Increased thirst
Peeing a lot
Feeling Thirsty
Extremely dehydrated in
If hyperglycaemia persists –
Nausea , vomiting
Abdominal pain
Confused and lethargic
Hard to wake up
Deep fast breathing
Fruity odour breath (due to ketone bodies)
DKA that is not treated promptly can result in a diabetic coma. The presence of too much acid in the blood causes the body to malfunction and can result in unconsciousness.
How is DKA diagnosed?
A child with symptoms of DKA should be immediately brought to the emergency department where blood and urine tests are done to confirm the diagnosis. The tests assess the levels of sugar, ketones, and acid in the blood, as well as the levels of ketones and sugar in the urine.
How is DKA treated?
DKA is a medical emergency that requires immediate treatment. The primary goals of DKA treatment are to reduce elevated blood sugar levels and correct dehydration. This is accomplished by administering insulin injections to decrease sugar levels in the body and providing intravenous fluids to manage dehydration. By addressing these two aspects, the abnormal levels of ketone bodies in the bloodstream should normalize naturally. In some cases, if necessary, bicarbonate may be administered to counteract acidosis.
In addition to the core treatments mentioned above, adjunctive therapies may be utilized to support the patient's recovery. For instance, potassium injections may be given to restore and maintain proper electrolyte balance, as DKA can often lead to potassium depletion. Antibiotics may also be prescribed in certain situations, especially if there is an underlying infection triggering or complicating the DKA episode.
Message for parents
Education is extremely important for this condition. It is essential to inform all adult family members, caregivers, and school staff about DKA and ensure they are aware of appropriate actions to take in case of an emergency. It is not uncommon for individuals with diabetes to experience occasional high blood sugar levels, despite adhering to their care plan. However, the key priority is to monitor your child's blood sugars daily, promptly address high readings, and recognize the signs of DKA.