Do you have diabetes? You must know about the dangerous condition called DKA (Diabetic Ketoacidosis)

Are you someone who has diabetes? Then you must be constantly concerned about your blood sugar levels, right? But have you heard of a very serious condition that can even be life-threatening that comes with diabetes? That's what we're talking about today. This is medically called Diabetic Ketoacidosis , or (DKA) for short. It's very important for your safety to be well-informed about this.

Simply put, what is DKA?

Okay, let's put it this way. Insulin is a hormone that helps our body's cells use glucose, or sugar, for energy. When a person with diabetes doesn't have enough insulin, or when the insulin they have doesn't work properly, the cells can't use the sugar in the blood.

Then our body thinks, "Oh, I'm running out of energy." So the body uses another way to make energy. That's by burning the fat in the body. When fat is burned in this way, a chemical called ketones is released into the blood as a byproduct. It's normal to have some ketones. But when this process goes unchecked because there's no insulin, a lot of ketones build up in the blood. These ketones are a type of acid. So, when they build up in the blood, our blood becomes acidic.

If your blood sugar level is usually above 240 mg/dL , it is wise to check your ketone levels every 4-6 hours. A blood sugar level above 250 mg/dL is considered the beginning of DKA. If your blood sugar level is outside the normal range, talk to your doctor immediately .

When should you go to an emergency hospital (ETU)?

If your blood sugar level is 300 mg/dL or higher and it is not coming down, or if you continue to vomit, feel extremely tired, or have symptoms of DKA such as difficulty breathing, go to the nearest Emergency Department (ETU) immediately.

Are Ketoacidosis and Ketosis two different things?

Yes, although these two words sound similar, they are two completely different processes.

• Ketosis: This happens when you eat a diet low in carbohydrates (like bread, rice, pasta) (e.g., the keto diet). Then the body burns fat for energy. Here too, ketones are produced, but it happens in a controlled manner. Because there is enough insulin in the body. Ketosis is not a dangerous state.
• Ketoacidosis (DKA): This occurs due to a lack of insulin. Ketones build up in an uncontrolled amount, causing the blood to become acidic. This is life-threatening.

What are the symptoms of DKA?

Symptoms of DKA can come on quickly. Sometimes, a person is first diagnosed with diabetes after they have developed DKA. It is important to be aware of these symptoms.

What are the main causes of DKA?

Although the primary cause of DKA is a lack of insulin, there are several factors that can contribute to the condition.

• Not taking insulin correctly: This risk increases if you do not take the insulin dose prescribed by your doctor on time or if you skip a dose. Sometimes, using expired insulin can also be a cause.
• Illnesses: When you have a fever, cold, urinary tract infection (UTI), or pneumonia, your body produces stress hormones (like cortisol and adrenaline). These hormones interfere with the function of insulin. Therefore, you are more likely to develop DKA on days when you are sick.
• Other effects on the body: The risk of DKA also increases due to increased stress on the body, such as having surgery, being in an accident, or having a heart attack or stroke.
• Undiagnosed diabetes: People who are unaware that they have diabetes, especially those with Type 1 diabetes, can develop DKA.
• Other causes: Excessive alcohol consumption, some drug use, pregnancy, and some medications (e.g. corticosteroids) can also cause DKA. If you have diabetes, it is important to tell your doctor before taking any new medication.

How can you prevent DKA from developing?

Fortunately, DKA is a preventable condition, and the key is to manage your diabetes well.

Here are some things you can do about it:

• Check your blood sugar levels regularly: Check your blood sugar levels several times a day, as directed by your doctor. Try to keep them within the recommended range.
• Take your medication correctly: Take your insulin or other diabetes medication at the right time, in the right dose. Never skip doses.
• Eat properly: Follow the meal plan given to you exactly.
• Drink plenty of water: Drink plenty of sugar-free fluids and water.
• Make a plan for sick days: Talk to your doctor in advance about how to check your blood sugar and ketone levels when you have a fever or cold, and whether you need to change your insulin dose.
• Check for ketones: Check for ketones any time your blood sugar is higher than 240 mg/dL. You can do this using urine strips or some glucometers.
• Be prepared for an emergency: Plan in advance what to do and where to go if DKA symptoms appear.

What are the treatments for DKA in the hospital?

When you go to an ETU with symptoms of DKA, doctors will take quick steps to control your condition. This treatment is usually given in the hospital.

1. Intravenous fluids: Saline is given intravenously to control dehydration and correct the chemical balance of the blood.

2. Insulin: Insulin is given intravenously to stop the formation of ketones and control blood sugar levels.

3. Electrolyte Replacement: DKA causes the body to lose essential minerals (electrolytes) like sodium and potassium. Since these are essential for the functioning of the heart, muscles, and nerves, they are replaced through saline.

4. Treatment for infections: If the cause of DKA is an infection, antibiotics are given.

The condition can usually be controlled within 24 hours, but if the condition is serious, it may take longer.

Diabetes, Diabetic Ketoacidosis, DKA, Ketones, Insulin, Blood Sugar, Diabetes Complications, Emergency Treatment