The Facts
Diabetic ketoacidosis (DKA) is a condition that may occur in people who have diabetes, in particular those who have type 1 (insulin-dependent) diabetes. It involves the buildup of toxic substances called ketones that make the blood too acidic. High ketone levels can be readily managed, but if they aren't detected and treated in time, a person can eventually slip into a coma and die.
DKA can occur in people who are newly diagnosed with type 1 diabetes and have had ketones building up in their blood prior to the start of treatment. However, 75% of the time, ketoacidosis occurs in individuals already receiving treatment for diabetes. DKA and low blood glucose are two major reasons that people with type 1 diabetes are admitted to hospital for emergency treatment, and DKA accounts for about 85% of cases.
Causes
With type 1 diabetes, the pancreas is unable to make the hormone insulin, which the body's cells need in order to take glucose in from the blood. Glucose - a simple sugar we get from the food we eat - is necessary for making the energy our cells need to function. People with type 1 diabetes can't get glucose into their cells, and so their bodies look for alternative energy sources. Meanwhile, glucose builds up in the bloodstream, and by the time DKA occurs, blood glucose levels are often greater than 22 mmol/L (400 mg/dL), while insulin levels are very low.
Since glucose isn't available for cells to use, fat from fat cells is broken down for energy instead, releasing ketones. Ketones accumulate in the blood causing it to become more acidic. As a result, many of the enzymes that control the body's metabolic processes aren't able to function as well. A higher level of ketones also affects levels of sugar and electrolytes in the body.
DKA may occur with insulin deficiency, under the following circumstances:
- during an infection or illness
- after stressful events or trauma (including heart attack or stroke)
- inadequate insulin treatment (for instance, by an undiagnosed individual)
With type 1 diabetes, the pancreas is unable to make the hormone insulin, which the body's cells need in order to take glucose in from the blood. Glucose - a simple sugar we get from the food we eat - is necessary for making the energy our cells need to function. People with type 1 diabetes can't get glucose into their cells, and so their bodies look for alternative energy sources. Meanwhile, glucose builds up in the bloodstream, and by the time DKA occurs, blood glucose levels are often greater than 22 mmol/L (400 mg/dL), while insulin levels are very low.
Since glucose isn't available for cells to use, fat from fat cells is broken down for energy instead, releasing ketones. Ketones accumulate in the blood causing it to become more acidic. As a result, many of the enzymes that control the body's metabolic processes aren't able to function as well. A higher level of ketones also affects levels of sugar and electrolytes in the body.
DKA may occur with insulin deficiency, under the following circumstances:
- during an infection or illness
- after stressful events or trauma (including heart attack or stroke)
- inadequate insulin treatment (for instance, by an undiagnosed individual)
