Endocrine » Diabetes

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a state of absolute or relative insulin deficiency aggravated by ensuing hyperglycaemia, dehydration, and acidosis-producing derangements in intermediary metabolism. The most common causes are underlying infection, disruption of insulin treatment, and new onset of diabetes. DKA is typically characterized by hyperglycaemia over 300 mg/dL, low bicarbonate (< 15 mEq/L), and acidosis (pH < 7.30) with ketonaemia and ketonuria. Resuscitation is a critical part of treating DKA. Intravenous (IV) solutions replace extravascular and intravascular fluids and electrolyte losses. They also dilute both the glucose level and the levels of circulating counter-regulatory hormones. Insulin is needed to help switch from a catabolic to an anabolic state, with uptake of glucose in tissues and the reduction of gluconeogenesis as well as free fatty acid and ketone production.

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