What is DKA?
DKA is Diabetic Ketoacidosis. DKA is caused by an absence or markedly inadequate amount of insulin. This results in disorders in the metabolism of carbohydrates, protein, and fat.
The three main clinical features of DKA are;
(1) hyperglycemia, due to decreased use of glucose by the cells and increased production of glucose by the liver.
(2) dehydration and electrolyte loss, resulting from polyuria, with a loss of up to 6.5 L of water and up to 400 to 500 mEq each of sodium, potassium, and chloride over 24 hours.
(3) acidosis, due to an excess breakdown of fat to fatty acids and production of ketone bodies, which are also acids.
Three main causes of DKA are decreased or missed dose of insulin, illness or infection, and initial manifestation of undiagnosed or untreated diabetes.
The symptoms are;
• Polyuria and polydipsia (increased thirst).
• Blurred vision, weakness, and headache.
• Orthostatic hypotension.
• Frank hypotension with weak, rapid pulse.
• Gastrointestinal symptoms, such as anorexia, nausea/vomiting, and abdominal pain (may be severe).
• Acetone breath (fruity odor).
• Kussmaul respirations: hyperventilation with very deep, but not labored, respirations.
• Mental status varies widely from patient to patient (alert to lethargic or comatose).