Diabetic ketoacidosis

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In medicine, diabetic ketoacidosis (DKA) is a type of metabolic acidosis that is a "life-threatening complication of diabetes mellitus, primarily of Type 1 Diabetes Mellitus with severe insulin deficiency and hyperglycemia. It is characterized by excessive lipolysis, oxidation of fatty acids, production of ketone bodies, a sweet smell to the breath (ketosis;) dehydration; and depressed consciousness leading to coma.[1] can also occur with Diabetes mellitus type 2[2]

Treatment begins with fluid replacement; insulin is not started immediately. It is often secondary to infection or other comorbidity, which must be diagnosed and treated.[3][4]As it is treated, DKA converts from a high anion gap metabolic acidosis to a normal anion gap metabolic acidosis due to "excretion of ketone anions in the urine"[5], especially if excreted with sodium or potassium cations.

References

  1. Anonymous (2024), Diabetic ketoacidosis (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Umpierrez GE, Smiley D, Kitabchi AE (2006). "Narrative review: ketosis-prone type 2 diabetes mellitus.". Ann Intern Med 144 (5): 350-7. PMID 16520476.
  3. Wilson JF (2010). "In clinic. Diabetic ketoacidosis.". Ann Intern Med 152 (1): ITC1. DOI:10.1059/0003-4819-152-1-201001050-01001. PMID 20048266. Research Blogging.
  4. Rucker DW (February 12, 2008), "Diabetic ketoacidosis", eMedicine
  5. Oh MS, Carroll HJ, Goldstein DA, Fein IA (December 1978). "Hyperchloremic acidosis during the recovery phase of diabetic ketosis". Ann. Intern. Med. 89 (6): 925–7. PMID 102229[e]