diabetestalk.net

Dka Death Rate

Cardiovascular Complications Of Ketoacidosis

Cardiovascular Complications Of Ketoacidosis

US Pharm. 2016;41(2):39-42. ABSTRACT: Ketoacidosis is a serious medical emergency requiring hospitalization. It is most commonly associated with diabetes and alcoholism, but each type is treated differently. Some treatments for ketoacidosis, such as insulin and potassium, are considered high-alert medications, and others could result in electrolyte imbalances. Several cardiovascular complications are associated with ketoacidosis as a result of electrolyte imbalances, including arrhythmias, ECG changes, ventricular tachycardia, and cardiac arrest, which can be prevented with appropriate initial treatment. Acute myocardial infarction can predispose patients with diabetes to ketoacidosis and worsen their cardiovascular outcomes. Cardiopulmonary complications such as pulmonary edema and respiratory failure have also been seen with ketoacidosis. Overall, the mortality rate of ketoacidosis is low with proper and urgent medical treatment. Hospital pharmacists can help ensure standardization and improve the safety of pharmacotherapy for ketoacidosis. In the outpatient setting, pharmacists can educate patients on prevention of ketoacidosis and when to seek medical attention. Metabolic acidosis occurs as a result of increased endogenous acid production, a decrease in bicarbonate, or a buildup of endogenous acids.1 Ketoacidosis is a metabolic disorder in which regulation of ketones is disrupted, leading to excess secretion, accumulation, and ultimately a decrease in the blood pH.2 Acidosis is defined by a serum pH <7.35, while a pH <6.8 is considered incompatible with life.1,3 Ketone formation occurs by breakdown of fatty acids. Insulin inhibits beta-oxidation of fatty acids; thus, low levels of insulin accelerate ketone formation, which can be seen in patients with diabetes. Extr Continue reading >>

Recurrent Diabetic Ketoacidosis Raises Mortality Risk In T1d

Recurrent Diabetic Ketoacidosis Raises Mortality Risk In T1d

Recurrent episodes of diabetic ketoacidosis (DKA) were associated with a substantially increased risk of death in patients with type 1 diabetes, according to a retrospective cohort study. Patients with a single hospitalization for DKA during the study period had a 5.2% risk of death, compared with a 23.4% risk of death for patients hospitalized for DKA more than five times (hazard ratio 6.18; P=0.001), reported a research team led by Fraser Gibb, MBChB, PhD, of the Royal Infirmary of Edinburgh in Scotland. Patients with recurrent hospitalizations for DKA tended to be younger, poorer, have higher glycated hemoglobin levels, and to have mental health problems, Gibb and colleagues reported in Diabetologia. "Most strikingly, a greater than one in five risk of death was observed in those with the highest frequency of DKA presentation over a median 2.4 years of follow-up, compared with a one in 20 risk of death in those with a single DKA admission over a median of 4 years. This represents a substantially elevated risk of death when compared with the Scottish type 1 diabetes population," Gibb and colleagues said. "The main implications of the study are that we have identified a significant risk of death in patients with recurrent DKA, many of whom are young," Gibb told MedPage Today via email. "With this in mind, we need to build an evidence base for strategies to help prevent mortality in this at-risk group. I suspect this will focus on community-based, multi-disciplinary care for this group of patients." The deaths almost always occurred at home rather than in the hospital, the investigators noted. "In keeping with other modern cohorts, we found a low rate of inpatient mortality in patients presenting with DKA," they said. "However, the frequency of subsequent sudden death a Continue reading >>

The Occurrence Of Diabetic Ketoacidosis In

The Occurrence Of Diabetic Ketoacidosis In

Type 2 Diabetic Adults Chih-Hsun Chu; Jenn-Kuen Lee; Hing-Chung Lam; Chih-Chen Lu Division of Endocrinology and Metabolism, Department of Medicine, Veterans General Hospital-Kaohsiung, School of Medicine, National Yang-Ming University, Taipei, Taiwan. Running title: The Occurrence of Diabetic Ketoacidosis in Type 2 Diabetic Adults Abstract OBJECTIVE. To study the diabetic ketoacidosis (DKA) episodes which occurred in the type 2 diabetic adults. STUDY DESIGN. We reviewed retrospectively the charts of patients who were admitted to the division of endocrinology and metabolism from Jan. 1991 to Dec. 1997 due to DKA. RESULTS. Total 121 adult patients with 137 episodes (57 females and 80 males) of DKA, with mean age of 45.90 years. 98 episodes (71.5%) occurred in type 2 diabetes mellitus (DM) with mean age of 48.73, which was significantly older than type 1 diabetic patients. Among ten patients suffered from repeated episodes of DKA, 2 four patients belonged to type 2 DM. 33 episodes (24.1%) occurred in patients without a history of DM, however, up to 24 episodes were classified as in type 2. Infection was the most important precipitating factor in type 2 diabetic patients, with respiratory tract and urinary tract accounting for the two most common foci. In type 1 diabetic patients, poor drug compliance accounted for the leading one. Twelve patients (one in type 1 DM and eleven in type 2 DM) expired, giving the mortality rate of 8.8%. Only old age contributed to fatality in type 2 diabetic patients. Type 2 diabetic patients had lower value of serum potassium and the occurrence of hyperkalemia was less than that of type 1. CONCLUSION. Owing to high percentage of adult DKA episodes occurred in type 2 DM, more attention should be pay to these patients. KEYWORDS: diabetes mellitu Continue reading >>

Outcome Of Patients With Diabetic Ketoacidosis And Acute Respiratory Failure

Outcome Of Patients With Diabetic Ketoacidosis And Acute Respiratory Failure

Abstract SESSION TITLE: Respiratory Support Posters SESSION TYPE: Original Investigation Poster PURPOSE: Diabetic ketoacidosis (DKA) is a life threatening metabolic derangement. Acute respiratory failure in DKA is a strong mortality predictor and is usually secondary to both a decreased level of consciousness and severe acidosis. We assessed the outcome of patients admitted with DKA and acute respiratory failure. METHODS: A retrospective cohort analysis was done on patients admitted to our hospital with DKA and acute respiratory failure between January 2008 and December 2013. The baseline demographic information, clinical and laboratory characteristics were collected. The primary outcome of the study was in-hospital mortality. A univariate analysis was done to identify association of variables with the outcome. Continuous variables were reported as mean (SD) and compared via the student t test. Comparison of categorical data was made via the chi-square test. RESULTS: The cohort consisted of 76 patients admitted with diabetic ketoacidosis and acute respiratory failure. Of these patients, 28 deaths were noted resulting in a mortality rate of 37%. On univariate analysis, the presence of shock on admission and infection were significantly associated with mortality with a p value of 0.004 and 0.03 respectively. Pneumonia was the cause of death in 9 patients (32%). The potential of hydrogen (pH) was not statistically associated with mortality {Alive 7.12 vs dead 7.15; p value 0.42}, while the anion gap was statistically lower in patients who died {Dead 21.4 vs. alive 27; p value 0.001}. CONCLUSIONS: Mortality rate for diabetic ketoacidosis has significantly decreased with insulin therapy, however, patients with acute respiratory failure and altered mental status have a higher Continue reading >>

Trends In Diabetic Ketoacidosis Death Rates Among Adults With Diabetes, United States, 1984-2002

Trends In Diabetic Ketoacidosis Death Rates Among Adults With Diabetes, United States, 1984-2002

Trends in Diabetic Ketoacidosis Death Rates among Adults with Diabetes, United States, 1984-2002 Diabetes ketoacidosis (DKA) is Diabetes ketoacidosis (DKA) is a potential life-threatening complication of diabetes for which effective prevention and treatment strategies exist. The purpose of this study is to examine trends in DKA death rates from 1984 to 2002 among persons with diabetes aged 18 years and older. Deaths with DKA as underlying cause were identified from vital records and the number of people with diabetes was estimated from National Health Interview Survey. We age-adjusted death rates using the 2000 U.S. population as the standard and tested for trends using linear regression. During the study period, the age-adjusted DKA death rate decreased by one third, from 30.5 to 20.5 per 100,000 diabetic population (p for trend[lt]0.01). DKA death rates declined in all age groups with the greatest decrease among those 65 years or older (65% decrease, p[lt]0.01)). Persons aged 18-44 years had the highest rates which were over twice that of older persons. Age-adjusted DKA death rates declined for white males and females and black females (p[lt]0.05) but not for black males whose rates were generally at least twice that of the other groups. From 1992 through 2002, rates for DKA death occurring in all healthcare sites declined (49% decrease for hospital, 38% for emergency rooms/outpatient clinics, and 59% for nursing home (p[lt]0.01)) but the rates for death occurring at residence did not. In 2002, 52% of DKA deaths occurred in hospital, 12% at emergency rooms or outpatient clinics, 26% at residence and 10% at other places. In conclusion, downward trends in DKA death rates were observed in almost all subgroups, implying reduced DKA incidence and/or improved clinical pract Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Runa Acharya, MD, University of Iowa-Des Moines Internal Medicine Residency Program at UnityPoint Health, Des Moines, IA. Udaya M. Kabadi, MD, FACP, FRCP(C), FACE, Veteran Affairs Medical Center and Broadlawns Medical Center, Des Moines, IA; Des Moines University of Osteopathic Medicine, Iowa City; and University of Iowa Carver College of Medicine, Iowa City; Adjunct Professor of Medicine and Endocrinology, University of Iowa, Iowa City, and Des Moines University, Des Moines. Peer Reviewer Jay Shubrook, DO, FAAFP, FACOFP, Professor, Primary Care Department, Touro University, College of Osteopathic Medicine, Vallejo, CA. To reveal any potential bias in this publication, and in accordance with Accreditation Council for Continuing Medical Education guidelines, we disclose that Dr. Farel (CME question reviewer) owns stock in Johnson & Johnson. Dr. Stapczynski (editor) owns stock in Pfizer, Johnson & Johnson, Walgreens Boots Alliance Inc., GlaxoSmithKline, Bristol Myers Squibb, and AxoGen. Dr. Wise (editor) reports he is on the speakers bureau for the Medicines Company. Dr. Kabadi (author) reports he is a consultant and on the speakers bureau for Sanofi. Dr. Shubrook (peer reviewer) reports he receives grant/research support from Sanofi and is a consultant for Eil Lilly, Novo Nordisk, and Astra Zeneca. Dr. Schneider (editor), Dr. Acharya (author), Ms. Coplin (executive editor), Ms. Mark (executive editor), Mr. Landenberger (editorial and continuing education director), and Mr. Springston (associate managing editor) report no financial relationships relevant to this field of study. EXECUTIVE SUMMARY Diabetic ketoacidosis typically occurs at the onset of Type 1 diabetes mellitus, but also may occur from withdrawal or omission of insulin therapy in patients due to psychiatric, Continue reading >>

Short-term Case Fatality Rate And Associated Factors Among Inpatients With Diabetic Ketoacidosis And Hyperglycemic Hyperosmolar State: A Hospital-based Analysis Over A 15-year Period

Short-term Case Fatality Rate And Associated Factors Among Inpatients With Diabetic Ketoacidosis And Hyperglycemic Hyperosmolar State: A Hospital-based Analysis Over A 15-year Period

Background and Purpose Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are usually life threatening, but the recent trend of 28-day case-fatality and associated risk factors including Charlson index have not been known. Our aim was to evaluate the 28-day case-fatality rate among hospitalized DKA and HHS patients in a teaching hospital in Taiwan from 1991 to 2005. Methods DKA and HHS admissions, identified from in-patient electronic database, were linked to Taiwan's national death registry. Kaplan-Meier analysis was used to determine the 28-day case-fatality rates of DKA and HHS, and to compare the trend of case-fatality over three consecutive 5-year periods (i.e, 1991-1995, 1996-2000, 2001-2005). We also used the Cox proportional hazard regression model to explore the determinants of 28-day case-fatality of the study patients. Results The 28-day case-fatality rates for DKA and HHS were 6.10% and 18.83%, and the lowest ones were observed in 2001-2005 (2.65% and 11.63% in DKA and HHS, respectively). Pneumonia was a significant predictor for increased 28-day case-fatality in both illnesses. Additionally, older age and stroke were significantly associated with increased case-fatality in DKA patients while myocardial infarction and higher Charlson index were significant predictors for higher case-fatality in HHS patients. Conclusion Improvements in case-fatality in recent years for both DKA and HHS were found in the study hospital. Further reduction of the case-fatality rate among DKA and HHS patients can be achieved by optimal management of certain co-morbidities. Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Patient professional reference Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Pre-diabetes (Impaired Glucose Tolerance) article more useful, or one of our other health articles. See also the separate Childhood Ketoacidosis article. Diabetic ketoacidosis (DKA) is a medical emergency with a significant morbidity and mortality. It should be diagnosed promptly and managed intensively. DKA is characterised by hyperglycaemia, acidosis and ketonaemia:[1] Ketonaemia (3 mmol/L and over), or significant ketonuria (more than 2+ on standard urine sticks). Blood glucose over 11 mmol/L or known diabetes mellitus (the degree of hyperglycaemia is not a reliable indicator of DKA and the blood glucose may rarely be normal or only slightly elevated in DKA). Bicarbonate below 15 mmol/L and/or venous pH less than 7.3. However, hyperglycaemia may not always be present and low blood ketone levels (<3 mmol/L) do not always exclude DKA.[2] Epidemiology DKA is normally seen in people with type 1 diabetes. Data from the UK National Diabetes Audit show a crude one-year incidence of 3.6% among people with type 1 diabetes. In the UK nearly 4% of people with type 1 diabetes experience DKA each year. About 6% of cases of DKA occur in adults newly presenting with type 1 diabetes. About 8% of episodes occur in hospital patients who did not primarily present with DKA.[2] However, DKA may also occur in people with type 2 diabetes, although people with type 2 diabetes are much more likely to have a hyperosmolar hyperglycaemic state. Ketosis-prone type 2 diabetes tends to be more common in older, overweight, non-white people with type 2 diabetes, and DKA may be their Continue reading >>

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (dka)

Tweet Diabetic ketoacidosis (DKA) is a dangerous complication faced by people with diabetes which happens when the body starts running out of insulin. DKA is most commonly associated with type 1 diabetes, however, people with type 2 diabetes that produce very little of their own insulin may also be affected. Ketoacidosis is a serious short term complication which can result in coma or even death if it is not treated quickly. Read about Diabetes and Ketones What is diabetic ketoacidosis? DKA occurs when the body has insufficient insulin to allow enough glucose to enter cells, and so the body switches to burning fatty acids and producing acidic ketone bodies. A high level of ketone bodies in the blood can cause particularly severe illness. Symptoms of DKA Diabetic ketoacidosis may itself be the symptom of undiagnosed type 1 diabetes. Typical symptoms of diabetic ketoacidosis include: Vomiting Dehydration An unusual smell on the breath –sometimes compared to the smell of pear drops Deep laboured breathing (called kussmaul breathing) or hyperventilation Rapid heartbeat Confusion and disorientation Symptoms of diabetic ketoacidosis usually evolve over a 24 hour period if blood glucose levels become and remain too high (hyperglycemia). Causes and risk factors for diabetic ketoacidosis As noted above, DKA is caused by the body having too little insulin to allow cells to take in glucose for energy. This may happen for a number of reasons including: Having blood glucose levels consistently over 15 mmol/l Missing insulin injections If a fault has developed in your insulin pen or insulin pump As a result of illness or infections High or prolonged levels of stress Excessive alcohol consumption DKA may also occur prior to a diagnosis of type 1 diabetes. Ketoacidosis can occasional Continue reading >>

Diabetes With Ketone Bodies In Dogs

Diabetes With Ketone Bodies In Dogs

Studies show that female dogs (particularly non-spayed) are more prone to DKA, as are older canines. Diabetic ketoacidosis is best classified through the presence of ketones that exist in the liver, which are directly correlated to the lack of insulin being produced in the body. This is a very serious complication, requiring immediate veterinary intervention. Although a number of dogs can be affected mildly, the majority are very ill. Some dogs will not recover despite treatment, and concurrent disease has been documented in 70% of canines diagnosed with DKA. Diabetes with ketone bodies is also described in veterinary terms as diabetic ketoacidosis or DKA. It is a severe complication of diabetes mellitus. Excess ketone bodies result in acidosis and electrolyte abnormalities, which can lead to a crisis situation for your dog. If left in an untreated state, this condition can and will be fatal. Some dogs who are suffering from diabetic ketoacidosis may present as systemically well. Others will show severe illness. Symptoms may be seen as listed below: Change in appetite (either increase or decrease) Increased thirst Frequent urination Vomiting Abdominal pain Mental dullness Coughing Fatigue or weakness Weight loss Sometimes sweet smelling breath is evident Slow, deep respiration. There may also be other symptoms present that accompany diseases that can trigger DKA, such as hypothyroidism or Cushing’s disease. While some dogs may live fairly normal lives with this condition before it is diagnosed, most canines who become sick will do so within a week of the start of the illness. There are four influences that can bring on DKA: Fasting Insulin deficiency as a result of unknown and untreated diabetes, or insulin deficiency due to an underlying disease that in turn exacerba Continue reading >>

National Diabetes Audit - 2011-12: Report 2

National Diabetes Audit - 2011-12: Report 2

Summary 2011-2012 National Diabetes Audit (NDA) report. Report 2 shows Complications and Mortality This national report from the ninth year of the NDA, presents key findings on complications in 2010-2012 and deaths in 2012 for all age groups. This report presents statistics about diabetes outcomes including Diabetic Ketoacidosis (DKA), chronic kidney disease and treatment of end stage disease (renal replacement therapy, RRT), lower limb amputations, retinopathy treatment, heart disease, stroke and mortality. Due to the size of this publication, the data have been organised alphabetically by CCG/LHB profile and split into several pages, which are linked to above. Key Facts More than a quarter of admissions to hospital with heart failure involve a patient with diabetes (28 per cent, or 198,200 of 717,100 admissions during 2010-2012). The National Diabetes Audit published today recorded over two million patients with diabetes and shows people with diabetes have a 74 per cent greater risk of being admitted to hospital for heart failure compared to the rest of the population. Of the 198,100 people in the audit with type 1 diabetes in England and Wales in 2012, 3,300 died during the year, whereas 1,440 would have been expected among the same number of the general population, giving a 130 per cent increased risk of death for people with this form of diabetes. Of the 1.9million people in the audit with type 2 diabetes in England and Wales in 2012, 70,900 died during the year, whereas 52,800 would have been expected among the same number of the general population, giving a 35 per cent increased risk of death for people with this form of diabetes. The risk of premature death for people with diabetes. compared to their peers in the general population (relative risk) is greatest fo Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Practice Essentials Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication of diabetes that mainly occurs in patients with type 1 diabetes, but it is not uncommon in some patients with type 2 diabetes. This condition is a complex disordered metabolic state characterized by hyperglycemia, ketoacidosis, and ketonuria. Signs and symptoms The most common early symptoms of DKA are the insidious increase in polydipsia and polyuria. The following are other signs and symptoms of DKA: Nausea and vomiting; may be associated with diffuse abdominal pain, decreased appetite, and anorexia History of failure to comply with insulin therapy or missed insulin injections due to vomiting or psychological reasons or history of mechanical failure of insulin infusion pump Altered consciousness (eg, mild disorientation, confusion); frank coma is uncommon but may occur when the condition is neglected or with severe dehydration/acidosis Signs and symptoms of DKA associated with possible intercurrent infection are as follows: See Clinical Presentation for more detail. Diagnosis On examination, general findings of DKA may include the following: Characteristic acetone (ketotic) breath odor In addition, evaluate patients for signs of possible intercurrent illnesses such as MI, UTI, pneumonia, and perinephric abscess. Search for signs of infection is mandatory in all cases. Testing Initial and repeat laboratory studies for patients with DKA include the following: Serum electrolyte levels (eg, potassium, sodium, chloride, magnesium, calcium, phosphorus) Note that high serum glucose levels may lead to dilutional hyponatremia; high triglyceride levels may lead to factitious low glucose levels; and high levels of ketone bodies may lead to factitious elevation of creatinine levels. Continue reading >>

Diabetic Ketoacidosis Causes, Symptoms, Treatment, And Complications

Diabetic Ketoacidosis Causes, Symptoms, Treatment, And Complications

Diabetic ketoacidosis definition and facts Diabetic ketoacidosis is a life-threatening complication of type 1 diabetes (though rare, it can occur in people with type 2 diabetes) that occurs when the body produces high levels of ketones due to lack of insulin. Diabetic ketoacidosis occurs when the body cannot produce enough insulin. The signs and symptoms of diabetic ketoacidosis include Risk factors for diabetic ketoacidosis are type 1 diabetes, and missing insulin doses frequently, or being exposed to a stressor requiring higher insulin doses (infection, etc). Diabetic ketoacidosis is diagnosed by an elevated blood sugar (glucose) level, elevated blood ketones and acidity of the blood (acidosis). The treatment for diabetic ketoacidosis is insulin, fluids and electrolyte therapy. Diabetic ketoacidosis can be prevented by taking insulin as prescribed and monitoring glucose and ketone levels. The prognosis for a person with diabetic ketoacidosis depends on the severity of the disease and the other underlying medical conditions. Diabetic ketoacidosis (DKA) is a severe and life-threatening complication of diabetes. Diabetic ketoacidosis occurs when the cells in our body do not receive the sugar (glucose) they need for energy. This happens while there is plenty of glucose in the bloodstream, but not enough insulin to help convert glucose for use in the cells. The body recognizes this and starts breaking down muscle and fat for energy. This breakdown produces ketones (also called fatty acids), which cause an imbalance in our electrolyte system leading to the ketoacidosis (a metabolic acidosis). The sugar that cannot be used because of the lack of insulin stays in the bloodstream (rather than going into the cell and provide energy). The kidneys filter some of the glucose (suga Continue reading >>

Diabetic Ketoacidosis And Hyperglycemic Hyperosmolar Syndrome

Diabetic Ketoacidosis And Hyperglycemic Hyperosmolar Syndrome

In Brief Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS) are two acute complications of diabetes that can result in increased morbidity and mortality if not efficiently and effectively treated. Mortality rates are 2–5% for DKA and 15% for HHS, and mortality is usually a consequence of the underlying precipitating cause(s) rather than a result of the metabolic changes of hyperglycemia. Effective standardized treatment protocols, as well as prompt identification and treatment of the precipitating cause, are important factors affecting outcome. The two most common life-threatening complications of diabetes mellitus include diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar syndrome (HHS). Although there are important differences in their pathogenesis, the basic underlying mechanism for both disorders is a reduction in the net effective concentration of circulating insulin coupled with a concomitant elevation of counterregulatory hormones (glucagon, catecholamines, cortisol, and growth hormone). These hyperglycemic emergencies continue to be important causes of morbidity and mortality among patients with diabetes. DKA is reported to be responsible for more than 100,000 hospital admissions per year in the United States1 and accounts for 4–9% of all hospital discharge summaries among patients with diabetes.1 The incidence of HHS is lower than DKA and accounts for <1% of all primary diabetic admissions.1 Most patients with DKA have type 1 diabetes; however, patients with type 2 diabetes are also at risk during the catabolic stress of acute illness.2 Contrary to popular belief, DKA is more common in adults than in children.1 In community-based studies, more than 40% of African-American patients with DKA were >40 years of age and more than 2 Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Professor of Pediatric Endocrinology University of Khartoum, Sudan Introduction DKA is a serious acute complications of Diabetes Mellitus. It carries significant risk of death and/or morbidity especially with delayed treatment. The prognosis of DKA is worse in the extremes of age, with a mortality rates of 5-10%. With the new advances of therapy, DKA mortality decreases to > 2%. Before discovery and use of Insulin (1922) the mortality was 100%. Epidemiology DKA is reported in 2-5% of known type 1 diabetic patients in industrialized countries, while it occurs in 35-40% of such patients in Africa. DKA at the time of first diagnosis of diabetes mellitus is reported in only 2-3% in western Europe, but is seen in 95% of diabetic children in Sudan. Similar results were reported from other African countries . Consequences The latter observation is annoying because it implies the following: The late diagnosis of type 1 diabetes in many developing countries particularly in Africa. The late presentation of DKA, which is associated with risk of morbidity & mortality Death of young children with DKA undiagnosed or wrongly diagnosed as malaria or meningitis. Pathophysiology Secondary to insulin deficiency, and the action of counter-regulatory hormones, blood glucose increases leading to hyperglycemia and glucosuria. Glucosuria causes an osmotic diuresis, leading to water & Na loss. In the absence of insulin activity the body fails to utilize glucose as fuel and uses fats instead. This leads to ketosis. Pathophysiology/2 The excess of ketone bodies will cause metabolic acidosis, the later is also aggravated by Lactic acidosis caused by dehydration & poor tissue perfusion. Vomiting due to an ileus, plus increased insensible water losses due to tachypnea will worsen the state of dehydr Continue reading >>

More in ketosis