Diabetic ketoacidosis

Diabetic ketoacidosis ( DKA ) is a state of insulin deficiency. When the glucose is unable to enter cells and accumulates within bloodstream, it triggers high blood sugar. Since body muscle and vital organs require energy to function, they have to dissolve body fat to provide energy; when a large amount of fat is broken down, it release fatty acids and ketone bodies in the blood. Also DKA develops when the blood has more acid than normal. The possible DKA etiology includes either newly diagnosed diabetes or external precipitating factors, such as infection and trauma, and etc. We strongly recommend you to comply with the following principles to prevent the development of diabetic ketoacidosis.

• Diabetes patients ought to actively follow 3 treatment principles: diet control, adequate exercise, plus medication.
• Collaborate with your physicians and nurses for long term treatment; stopping medication at will is forbidden.
• Look for doctor’s consultation immediately if there is need for diabetic treatment reinforcement for acute disorders and other diseases.
• Familiarize yourself with the symptoms of hyperglycemia: fatigue, rapid breathing, dry mouth and skin, frequent urination, extreme thirst, nausea, vomiting, abdominal pain, confusion or breath that smells fruity with a flushed face. If you are troubled by any of the aforementioned symptoms, visit the hospital as soon as possible.
• When ill, comply the following handling principles:

1. Frequently check on blood glucose level and urine ketons when you are infected or feverish; and note, blood glucose level tend to run high as you feel sick. Closely pay attention to the infection symptoms, fever, and partial redness, heat, and skin pain. If the blood sugar level is uncontrollable, visit the doctor immediately.
2. Drink more water to avoid dehydration during illness.
3. You may take oral antidiabetic drugs or insulin regularly during illness. Check with your doctor if you want to increase or decrease medication dosage.
4. During illness, take soft and digestible food.
5. When your urine sugar continues 3+ to 4+, or blood sugar remains high, nausea, abdominal pain, dyspnea, and sustained fever; visit the hospital as soon as possible.
6. With poor appetite, pay attention to medication usage. Beware: do not take oral anti-diabetic drugs or inject insulin under empty stomach.

Tests of blood  sugar levels are  commonly done. Testing for ketones in a sample of urine is one of the first steps for diagnosing DKA.  Other tests your doctor may order are:

1. arterial blood gas and chest X-ray—to determine the acidity of your blood and to look for signs of an infection such as pneumonia
2. amylase blood test—to test if there is pancreatitis if nausea, vomiting, abdominal pain is worsening.
3. potassium blood test—to assess if there is electrolyte imbalance.