This serious complication, the result of acid buildup in the blood, can lead to coma or even death.
If you have type 1 diabetes, one of the serious complications you may face is a condition known as ketoacidosis. In diabetic ketoacidosis, acids called ketones build up in your blood and could eventually lead to diabetic coma or death.
But by vigilantly controlling your diabetes and watching for early signs of ketoacidosis, you can help prevent it from happening to you.
What Is Diabetic Ketoacidosis?
"When blood sugars get elevated and there is not enough insulin, your fat cells start to break down their storage sites of energy, which are called ketones," says Jay Cohen, MD, medical director of the Endocrine Clinic and clinical assistant professor in the department of family medicine at the University of Tennessee. Ketones are acidic, and that acid builds up in your blood.
Diabetic ketoacidosis is found more often in younger people than older people, and more often in women than in men. At least 20 percent of people learn they have diabetes after seeking medical care for complaints that turn out to be symptoms of ketoacidosis.
Common Causes of Diabetic Ketoacidosis
The three common causes of ketoacidosis are:
Not enough insulin. This can happen if you don’t inject enough insulin or if your insulin needs increase in response to an illness such as a cold or the flu. Blood glucose can’t be used for energy without enough insulin to help in the process, so the body breaks down fat for energy and high ketone levels result.
"Elevated blood sugars could be due to an infection or any other physical or emotional stress — good or bad," says Dr. Cohen. Unexpected increases in your blood glucose levels can increase your insulin needs. "You may have a certain amount of insulin that you usually use, but if you have an infection, you may need more insulin to help your body to improve blood sugars," Cohen explains.
Not enough food intake. If you don’t eat enough, your body has to break down fat for energy, producing high ketone levels. This is particularly common in people who are sick and don't feel like eating.
Low blood glucose levels. This situation can force your body to break down fat to use as energy, resulting in ketone production.
Diabetic Ketoacidosis Symptoms
Symptoms of ketoacidosis usually progress relatively slowly. But since diabetic ketoacidosis can be a life-threatening condition, it is important to seek medical help immediately if you experience any of its symptoms. These include:
Elevated blood glucose levels
Elevated ketones in the urine
Skin that is dry or flushed
Nausea or vomiting
Pain in your abdomen
Shortness of breath
A fruity smell to your breath (the result of elevated ketone levels)
Inability to concentrate
Preventing Diabetic Ketoacidosis
Ask your endocrinologist how you can reduce your risk of developing diabetic ketoacidosis. It is often a good idea to use a home dipstick test to check for ketones in your urine when your blood glucose levels are high (over 240 milligrams per deciliter) and when you have an infection.
Diabetes education also helps. One study found that hospital stays for ketoacidosis were reduced among a group of people who attended diabetes education classes.
Managing Diabetic Ketoacidosis
If think you may have ketoacidosis, it is essential to contact your doctor or get to the emergency room immediately.
"If we can catch it early, with medicine and IV fluids, we can stop the diabetic ketoacidosis from progressing to severe dehydration," says Cohen. "Diabetic ketoacidosis, if severe and not treated aggressively, has about a 5 percent death rate, so you really want to get a handle on it rapidly."
Remember that regularly monitoring your blood glucose levels, performing urine ketone tests as recommended, and recognizing symptoms that might indicate your ketone levels are high is the best approach to reducing your risk of diabetic ketoacidosis.
From Everyday Health
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