A Brief Note On Diabetic Ketoacidosis And Diabetes

Ketosis is the metabolic state that most of the body's energy supply comes from ketone bodies in the blood, contrasting to the state of glycolysis in which blood glucose provides most of the energy (Taubes, 2011, 140-141). Ketosis might be better known as acetone breath, a common symptom of progressing diabetes mellitus type. It is characterized by serum concentrations of ketone bodies, with low and stable levels of insulin and blood glucose. It is commonly generalized with hyper-ketonemia, which is an elevated level of ketone bodies in the blood throughout the body. Ketone bodies are formed by ketogenesis as the liver glycogen stores are depleted (Taubes, 2011, p.155). The ketone bodies used for energy are acetoacetate and beta-hydroxybutyrate, with that, the levels of ketone bodies are regulated mainly by glucagon and insulin (p.156). Most cells can then be used by both glucose and ketone bodies for fuel, and during ketosis, free fatty acids and glucose synthesis fuel the rest.

Diabetes Mellitus is a growing issue for health care providers internationally. The World Health organization estimated in 2013 there were 347 Million diabetics worldwide, predicting that Diabetes will be the 7th leading cause of death by 2030 (WHO, 2013). In both type 1 and type 2 diabetes Mellitus, factors such as poor compliance with diet and medication, infection, acute medical or surgical illness or trauma can lead to poor glycaemic control, precipitating a hyperglycaemic emergency such as Diabetic Ketoacidosis (DKA) (Scobie & Samaras, 2009). In Type 2 Diabetes, another equally dangerous

During one of my rotations, I was assigned a young adult patient who had run out of insulin and had been admitted to the hospital following a Diabetes Ketoacidosis (DKA) episode. I realized that my patient was probably torn between buying insulin and buying healthy food because her chart showed several admissions in the

At Yale New Haven on the medicine floor SLA 4, the nurse manager identified the need of education on both the hyperglycemia and diabetic ketoacidosis protocols. The nurses and doctors were not aware of the steps outlined in the protocol that needed to be followed. There have been several incidents across the hospital of orders not being correctly prescribed by physicians and nurses following through with these incorrect orders, therefore seriously effecting patient outcomes. Specifically on SLA 4 there was a recent incidence of a patient coming off of an

Diabetic ketoacidosis is a dangerous state - nutritional ketosis, on the other hand, is where the body is using ketones as a fuel source safely. For those who don't have diabetes, having insulin to ensure good blood sugar levels keeps ketones at safe levels which is achieved by reducing carbohydrate-intake to below 50

Diabetes mellitus (DM) is a condition in the body that is related to a faulty metabolism. It means that the body’s metabolism is not functioning properly, which leads to adverse effects in the health. The food we ingest, gets broken down into blood sugar (glucose), which is what fuels our body in the form of energy. This converted glucose needs to enter our cells so that it can be used for energy and growth. And in order for the glucose to enter our cells, there needs to be insulin present, which the beta cells of the pancreas is responsible for producing. This hormone is responsible for maintaining glucose level in the blood. It allows the body cells to use glucose as a main

Classic symptoms of diabetes usually presented with newly diagnosed diabetics are: hyperglycaemia, polyuria, polydipsia, polyphagia, fatigue, blurred vision, headaches, and unexplained weight loss. Ketone bodies are found in the urine, this abnormal finding occurs when fatty acid by-products (acetones) are excreted in the urine. The ketones are present from a lack of the insulin hormone used to metabolize fats and carbohydrates. Diabetic ketoacidosis (DKA) is a life-threatening complication which results from minimal useful insulin hormone in the body, hypoglycaemia, or insufficient food intake (American Diabetes Association, 2008).

Diabetic Ketoacidosis (DKA) is a serious disease with complications that may have fatal results in some cases. DKA is defined as an insulin deficiency that occurs when glucose fails to enter insulin into muscles such as: liver and adipose tissue. When there is an accumulation of ketones, it leads to metabolic acidosis which causes nausea and vomiting, as a result fluid and electrolytes are loss (Gibbs). There are many complications of diabetic ketoacidosis, some of the most prevalent are: Cerebral Edema, Hypolglycemia, and Acute Pancreatitis.

Shannon’s history of being a DM1 since she was three years old directly relates to her current medical condition. Illnesses interfere with the management of diabetes because blood glucose levels are not regulated when intake of food and fluids is altered as well as the administration of insulin (Centers for Disease Control and Prevention [CDC], 2014). In addition, being ill usually causes stress on the body which increases the blood glucose levels (Robbins et al., 2010). Lastly, diabetes affects the immune system by disturbing humoral immunity, damaging neutrophil function, and depressing the antioxidant system. As a result the individual will be more susceptible to illness or have a reduced ability to fight microbes. Certain organisms thrive in hyperglycemic environments which make it harder for a diabetic clients immune system to control (Casqueiro, Casqueiro, & Alves, 2012). Since Shannon has not been eating and not taking insulin she has not been managing her diabetes during their illness appropriately. This means her body has not been able to process glucose for energy and has been forced to metabolize fat instead leading to the development of DKA (Robbins et al., 2010).

Diabetic Ketoacidosis (DKA) is a disease state, most often seen in individuals with Type I Diabetes. While it most often results from uncontrolled insulin levels, young children can often present in diabetic ketoacidosis as the initial presentation of undiagnosed type I Diabetes. The major symptoms of Type I Diabetes, polydipsia, polyphagia, and polyuria, are often subtle and can be normal in growing children (Urden, Stacy & Lough, 2014; Wilson, 2012). Unless alert to the symptoms of Diabetes they can often be overlooked until severe enough to warrant immediate medical attention.

Metabolic acidosis happens when the chemical balance of acids and bases in your blood gets thrown off. This can be triggered when the body; is producing too much acid, isn't getting rid of enough acid or doesn't have enough of a base to offset a normal amount of acid. When any of these occur, chemical reactions and processes in your body don't work right. Diabetics can suffer from a Metabolic acidosis know as Diabetic Ketoacidosis. Diabetic Ketoacidosis (DKA) is a life-threatening condition that develops when cells in the body are incapable to get the sugar (glucose) they need for energy because there is not adequate insulin. When the sugar cannot enter into the cells, it stays in the blood. The kidneys filter some of the sugar from the blood

The problem with Mrs. Brown, is that she is found with Diabetic Ketoacidosis. Diabetic Ketoacidosis is when your body produces high glucose acid in the body. In this case, Mrs. Brown has high blood glucose. Meaning that she is metabolically acidosis. What her body is trying to attempt is to exhale the excessiveness of carbon dioxide in her body. Which having an excess of CO increases her respiratory rate. Mrs. Brown’s kidneys are reabsorbing bicarbonate ions at that very moment but is not enough to fight the

Diabetic acidosis is due to an increased amount of ketones in the bodies of those suffering from uncontrolled diabetes. Diabetics rely upon insulin as fuel to “run” the body and when the body is unable to use glucose it uses fat. Ketones are the “waste” that is left after fat is broken down for fuel, they are acid and when they build up in a diabetic’s blood and eventually urine, their kidney’s are unable to dispel it as fast as it is being used (Wisse, 2013). Since ketones are acidic any impairment in removal of the ketones or continued uncontrollable diabetes will cause the sudden change that could cause life-threatening complications and severe illness.

If ketones build up in the blood it becomes more acidic and if the levels get to high people can develop diabetic ketoacidosis (DKA). DKA is extremely dangerous and can lead to a diabetic coma or even death. It is rare in people with type 2 diabetes, but it can occur. Diabetes affect the kidneys as well leading to kidney disease or nephropathy.

Ketoacidosis in diabetics also referred to as Diabetic Ketoacidosis (DKA) is a serious medical condition caused by abnormal increase in quantities of ketones in the body, as result of some unregulated biochemical circumstances. It is the combination factor of an excess of glucose in the bloodstream and abnormally high concentration of ketone bodies in the blood. Insulin is the main hormone in relation to ketoacidosis in diabetics.