Materiały źródłowe

• #1 Adult Diabetic Ketoacidosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560723/

  Diabetic ketoacidosis (DKA) is characterized by uncontrolled hyperglycemia, metabolic acidosis, and increased body ketone concentration. It is a life-threatening complication of diabetes and is usually seen in patients with type-1 diabetes mellitus. Rarely it may also occur in patients with type-2 diabetes mellitus. DKA is a state of a relative or absolute insulin deficiency that is worsened by hyperglycemia, dehydration, and acidosis. In most cases, the trigger is an infection, new-onset diabetes, or lack of compliance with treatment. […] Diabetic ketoacidosis (DKA) is characterized by hyperglycemia, acidosis, and ketonemia. It is a life-threatening complication of diabetes and typically seen in patients with type-1 diabetes mellitus, though it may also occur in patients with type-2 diabetes mellitus. In most cases, the trigger is new-onset diabetes, an infection, or a lack of compliance with treatment.

• #2 Diabetic Ketoacidosis (DKA): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/118361-overview

  Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication of diabetes characterized by hyperglycemia, ketoacidosis, and ketonuria. […] The most common early symptoms of DKA are the insidious increase in polydipsia and polyuria. The following are other signs and symptoms of DKA: Malaise, generalized weakness, and fatigability; Nausea and vomiting; may be associated with diffuse abdominal pain, decreased appetite, and anorexia; Rapid weight loss in patients newly diagnosed with type 1 diabetes; 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; Decreased perspiration; Altered consciousness (eg, mild disorientation, confusion); frank coma is uncommon but may occur when the condition is neglected or with severe dehydration/acidosis.

• #3 Diabetic Ketoacidosis (DKA): Causes, Symptoms, Treatments

  https://www.webmd.com/diabetes/ketoacidosis

  Diabetic ketoacidosis symptoms can appear quickly and may even be your first warning sign that you have diabetes. The first signs of DKA can include: […] If you dont get medical help, you can have more DKA symptoms, including: […] Diabetic ketoacidosis can be very dangerous and even life-threatening. You should go to the emergency room right away if: […] If you have the symptoms described above, you should go to the emergency room or call 911, even if you havent been told you have diabetes. […] Diabetic ketoacidosis usually happens because your body doesn’t have enough insulin. Your cells can’t use the sugar in your blood for energy, so they use fat for fuel instead. Burning fat makes acids called ketones. If the process goes on for a while, they could build up in your blood. Having too many ketones can change the chemical balance of your blood and throw off your entire system.

• #4 Ketoacidosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534848/

  Ketoacidosis is a metabolic state associated with pathologically high serum and urine concentrations of ketone bodies. Clinically relevant forms of ketoacidoses include diabetic ketoacidosis (DKA), alcoholic ketoacidosis (AKA), and starvation ketoacidosis. DKA is a potentially life-threatening complication of uncontrolled diabetes. It typically occurs in the setting of hyperglycemia and insulin deficiency, which causes unopposed lipolysis and oxidation of free fatty acids and thereby results in ketone body production and a subsequent increased anion gap metabolic acidosis. […] The clinically relevant ketoacidoses to be discussed include diabetic ketoacidosis (DKA), alcoholic ketoacidosis (AKA), and starvation ketoacidosis. DKA is a potentially life-threatening complication of uncontrolled diabetes mellitus if not recognized and treated early. It typically occurs in the setting of hyperglycemia with relative or absolute insulin deficiency. The paucity of insulin causes unopposed lipolysis and oxidation of free fatty acids, resulting in ketone body production and subsequent increased anion gap metabolic acidosis.

• #5 Diabetes-Related Ketoacidosis (DKA): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21945-diabetic-ketoacidosis-dka

  Diabetes-related ketoacidosis is an acute complication, meaning it has a severe and sudden onset. DKA can develop within 24 hours. It begins relatively slowly but can rapidly get worse. If you’re vomiting, it could develop much more quickly. […] With prompt treatment, recovery from DKA typically happens within 24 hours. Full treatment of DKA happens when your blood sugar is less than 200 mg/dL and your blood pH is higher than 7.3. […] Depending on the severity of DKA, it could take multiple days before it’s fully treated.

• #6 Diabetic Ketoacidosis (DKA) – Warning Signs, Causes & Prevention

  https://diabetes.org/about-diabetes/complications/ketoacidosis-dka/dka-ketoacidosis-ketones

  Diabetic ketoacidosis (DKA) is life-threatening […] DKA is a serious condition that can lead to diabetic coma or even death. DKA usually develops slowly. But when vomiting occurs, this life-threatening condition can develop in a few hours. Early symptoms include the following: Thirst or a very dry mouth, Frequent urination, High blood glucose (blood sugar) levels, High levels of ketones in the urine. Then, other symptoms appear: Constantly feeling tired, Dry or flushed skin, Nausea, vomiting, or abdominal pain. Vomiting can be caused by many illnesses, not just ketoacidosis. If vomiting continues for more than two hours, contact your health care provider. Difficulty breathing, Fruity odor on breath, A hard time paying attention, or confusion. Warning! DKA is dangerous and serious. If you have any of the above symptoms, contact your health care provider IMMEDIATELY, or go to the nearest emergency room of your local hospital.

• #7 Diabetic ketoacidosis in children: Clinical features and diagnosis – UpToDate

  https://www.uptodate.com/contents/diabetic-ketoacidosis-in-children-clinical-features-and-diagnosis

  Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with type 1 diabetes mellitus. It occurs at the time of diagnosis of type 1 diabetes in approximately 30 to 40 percent of children in the United States. […] In children with established diabetes, DKA occurs at rates of 6 to 8 percent per year. […] DKA can also occur in children with type 2 diabetes (and particularly in African American adolescents with obesity), although at lower rates than those observed in type 1 diabetes.

• #8 Diabetic ketoacidosis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetic-ketoacidosis/symptoms-causes/syc-20371551

  Diabetic ketoacidosis symptoms often come on quickly, sometimes within 24 hours. For some, these symptoms may be the first sign of having diabetes. Symptoms might include: Being very thirsty, Urinating often, Feeling a need to throw up and throwing up, Having stomach pain, Being weak or tired, Being short of breath, Having fruity-scented breath, Being confused. […] More-certain signs of diabetic ketoacidosis which can show up in home blood and urine test kits include: High blood sugar level, High ketone levels in urine. […] You have many symptoms of diabetic ketoacidosis. These include excessive thirst, frequent urination, nausea and vomiting, stomach pain, weakness or fatigue, shortness of breath, fruity-scented breath, and confusion. […] Untreated, diabetic ketoacidosis can lead to loss of consciousness and, eventually, death.

• #9 Diabetes-Related Ketoacidosis (DKA): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21945-diabetic-ketoacidosis-dka

  Diabetes-related ketoacidosis (DKA) is a life-threatening complication that affects people with diabetes or undiagnosed diabetes. It requires immediate medical attention. […] Signs of diabetes-related ketoacidosis include extreme thirst, frequent urination, vomiting, fatigue and more. DKA is an acute complication, meaning it has a severe and sudden onset. It can develop within 24 hours. […] Early signs and symptoms of DKA include: Peeing more often than usual (frequent urination). Extreme thirst (polydipsia). Intense hunger (polyphagia). Signs of dehydration, like dry mouth, headache and flushed (red) skin. High amounts of ketones in your pee or blood (as shown by at-home tests). High blood sugar levels (over 250 mg/dL). […] More severe symptoms of DKA include: Nausea and vomiting. Abdominal pain. Rapid, deep breathing (Kussmaul breathing). Fruity-smelling breath. Feeling very tired or weak. Feeling disoriented or confused. Decreased alertness. Loss of consciousness.

• #10 Diabetic Ketoacidosis | Diabetes | CDC

  https://www.cdc.gov/diabetes/about/diabetic-ketoacidosis.html

  DKA is a serious complication of diabetes that can be life-threatening. DKA usually develops slowly. Early symptoms include being very thirsty and urinating a lot more than usual. If untreated, more severe symptoms can appear quickly, such as fast, deep breathing, dry skin and mouth, flushed face, fruity-smelling breath, headache, muscle stiffness or aches, being very tired, nausea and vomiting, and stomach pain. Sometimes DKA is the first sign of diabetes in people who haven’t yet been diagnosed. Elevated ketones are a sign of DKA. This is a medical emergency that needs to be treated immediately. High ketones can be an early sign of DKA, which is a medical emergency.

• #11 Diabetic Ketoacidosis | Endocrinology and Diabetes

  https://health.ucdavis.edu/conditions/endocrinology-diabetes/diabetes/diabetic-ketoacidosis

  Diabetic ketoacidosis (DKA) can quickly become a life-threatening emergency. […] Symptoms of DKA may not be obvious at first. They also tend to come on slowly, over several hours. […] In the early stages of DKA, you may notice: Abdominal (belly) pain, Dry mouth, Feeling very thirsty, Headache, Nausea, Urinating more than usual, Fruity-smelling breath. […] DKA can quickly become an emergency. If you notice these symptoms, call 911 or have someone drive you to the nearest emergency room: Confusion, Fast breathing or shortness of breath, Vomiting, Weakness or tiredness (difficult to wake up or not as alert as normal).

• #12 Diabetic ketoacidosis

  https://www.nhs.uk/conditions/diabetic-ketoacidosis/

  Symptoms of diabetic ketoacidosis (DKA) include: feeling thirsty, needing to pee more often, stomach pain, feeling sick or being sick, diarrhoea, breathing more deeply than usual, breath that smells fruity (like pear drop sweets or nail polish remover), feeling tired, sleepy or confused, blurred vision. […] The symptoms usually develop over 24 hours, but it can be faster. […] Diabetic ketoacidosis can be life threatening so it’s important to get treatment quickly.

• #13 Adult Diabetic Ketoacidosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560723/

  The patient with diabetic ketoacidosis may present with a myriad of symptoms and physical exam findings. Patients may have symptoms of hyperglycemia like polyphagia, polyuria, or polydipsia. As patients become more volume-depleted, they may experience decreased urine output, dry mouth, or decreased sweating indicative of dehydration. They may complain of many other symptoms, including anorexia, nausea, vomiting, abdominal pain, and weight loss. […] Commonly accepted criteria for diabetic ketoacidosis are blood glucose greater than 250 mg/dl, arterial pH less than 7.3, serum bicarbonate less than 15 mEq/l, and the presence of ketonemia or ketonuria. […] Diabetic ketoacidosis still carries a mortality rate of 0.2 to 2.5% in developing countries. Patients who present in a comatose state, hypothermia, and oliguria tend to have the worst outcomes. For most patients treated promptly, the outcomes are good, especially if the trigger is not an infection. Elderly patients with concurrent illnesses such as myocardial infarction, pneumonia, or sepsis tend to have long hospital stays and high mortality.

• #14 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Advanced-Diabetic-Ketoacidosis.aspx

  Diabetic ketoacidosis (DKA) is a dangerous condition characterized by a severe rise in blood sugar or hyperglycemia, depleted bodily fluids, shock, and in some cases unconsciousness. Coma and even death may occur if DKA is left untreated or if it becomes more severe due to excessive vomiting. […] In the early stages of DKA, the affected individual appears flushed and breathes rapidly and deeply. This is called hyperventilation. […] As the condition progresses, the skin may turn pale, cool and clammy, dehydration may begin to set in and the heart rate may become rapid and breathing shallow. […] Nausea, vomiting and severe abdominal cramps. […] Blurred vision […] Fruity or pungent smelling breath due to the presence of acetone and ketones in the breath.

• #15 Diabetic Ketoacidosis (DKA) – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/diabetic-ketoacidosis-dka

  Diabetic ketoacidosis (DKA) is an acute metabolic complication of diabetes characterized by hyperglycemia, hyperketonemia, and metabolic acidosis. It causes nausea, vomiting, and abdominal pain and can progress to cerebral edema, coma, and death. […] Symptoms and signs of diabetic ketoacidosis include symptoms of hyperglycemia with the addition of nausea, vomiting, and particularly in children abdominal pain. Lethargy and somnolence are symptoms of more severe decompensation. […] In the absence of timely treatment, DKA progresses to coma and death. […] Acute cerebral edema, a complication in about 1% of DKA patients, occurs primarily in children and less often in adolescents and young adults. […] The cause is not well understood but may be related to too-rapid reductions in serum osmolality or to brain ischemia. […] Overall mortality rates for diabetic ketoacidosis are 1, 2, 3). Another study had lower rates of persistent neurologic sequelae and death (4).

• #16 Diabetic Ketoacidosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0501/p1705.html

  A diagnosis of diabetic ketoacidosis requires the patients plasma glucose concentration to be above 250 mg per dL (although it usually is much higher), the pH level to be less than 7.30, and the bicarbonate level to be 18 mEq per L or less. […] DKA can develop in less than 24 hours. […] Patients with DKA usually present with polyuria, polydipsia, polyphagia, weakness, and Kussmauls respirations. Nausea and vomiting are present in 50 to 80 percent of patients, and abdominal pain is present in about 30 percent. […] Body temperature usually is normal or low, even with an infection. If the patients temperature is elevated, infection invariably is present. […] Signs of dehydration, such as dry mucous membranes, tachycardia, and hypotension, often are found. Most patients are about 10 percent dehydrated.

• #17 Diabetic Ketoacidosis (DKA): Symptoms, Causes, Treatment

  https://www.healthline.com/health/type-2-diabetes/ketoacidosis

  Diabetic ketoacidosis occurs when a person with diabetes type 1 or 2 has dangerously high levels of ketones in the body. It can be a medical emergency. […] DKA happens when your blood sugar is very high and acidic substances called ketones build up to dangerous levels in your body. […] Symptoms of DKA can appear quickly. […] Early symptoms of DKA can include: frequent urination, extreme thirst or dry mouth, high blood sugar levels, also known as hyperglycemia, high levels of ketones in the urine. […] As DKA progresses, more symptoms may appear: nausea or vomiting, abdominal pain, confusion, fruity-smelling breath, flushed face, fatigue or weakness, rapid breathing, dry skin, loss of consciousness, also known as fainting or syncope. […] DKA is a medical emergency. Call your local emergency services immediately if you think you may be experiencing DKA.

• #18 Diabetic Ketoacidosis (DKA): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/118361-overview

  On examination, general findings of DKA may include the following: Ill appearance; Dry skin; Labored respiration; Dry mucous membranes; Decreased skin turgor; Decreased reflexes; Characteristic acetone (ketotic) breath odor; Tachycardia; Hypotension; Tachypnea; Hypothermia. […] Mental status changes can be seen with mild-to-moderate DKA; more severe deterioration in mental status is typical with moderate-to-severe DKA. […] Progressive rise of blood concentration of these acidic organic substances initially leads to a state of ketonemia, although extracellular and intracellular body buffers can limit ketonemia in its early stages, as reflected by a normal arterial pH associated with a base deficit and a mild anion gap. […] When the accumulated ketones exceed the body’s capacity to extract them, they overflow into urine (ie, ketonuria). If the situation is not treated promptly, a greater accumulation of organic acids leads to frank clinical metabolic acidosis (ie, ketoacidosis), with a significant drop in pH and bicarbonate serum levels.

• #19 Diabetic Ketoacidosis (DKA) Signs and Symptoms – Diabetes Mellitus for Medicine

  https://www.picmonic.com/pathways/medicine/courses/standard/pathology-196/diabetes-mellitus-39303/diabetic-ketoacidosis-dka-signs-and-symptoms_1323

  Diabetic ketoacidosis (DKA) is a medical emergency and complication of diabetes. Symptoms of DKA include deep, labored Kussmaul respirations, dehydration, abdominal pain and nausea and vomiting. […] In severe DKA, patient breathing becomes rapid, labored and deep. This breathing pattern is termed Kussmaul respirations. […] Dehydration occurs rapidly and is very serious with DKA. […] Patients with excess ketone bodies and hyperglycemic crisis (as in DKA) experience abdominal pain. […] Accumulation of ketones and a hyperosmolar state manifests in nausea and vomiting in patients. […] Patients with severe DKA suffer from mental status changes and delirium, which often manifest as psychosis. […] Patients with DKA often have fruity breath odor.

• #20 Diabetic ketoacidosis – Wikipedia

  https://en.wikipedia.org/wiki/Diabetic_ketoacidosis

  Symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion and occasionally loss of consciousness. […] A person’s breath may develop a specific „fruity” or acetone smell. […] The onset of symptoms is usually rapid. […] The symptoms of an episode of diabetic ketoacidosis usually evolve over a period of about 24 hours. Predominant symptoms are nausea and vomiting, pronounced thirst, excessive urine production and abdominal pain that may be severe. […] In severe DKA, breathing becomes rapid and of a deep, gasping character, called „Kussmaul breathing”. […] In severe DKA, there may be confusion or a marked decrease in alertness, including coma. […] On physical examination there is usually clinical evidence of dehydration, such as a dry mouth and decreased skin turgor.

• #20 Diabetic ketoacidosis – Wikipedia

  https://en.wikipedia.org/wiki/Diabetic_ketoacidosis

  If the dehydration is profound enough to cause a decrease in the circulating blood volume, a rapid heart rate and low blood pressure may be observed. […] Small children with DKA are relatively prone to brain swelling, also called cerebral edema, which may cause headache, coma, loss of the pupillary light reflex, and can progress to death. […] Diabetic ketoacidosis arises because of a lack of insulin in the body. […] The average adult with DKA has a total body water shortage of about 6 liters (or 100 mL/kg), in addition to substantial shortages in sodium, potassium, chloride, phosphate, magnesium and calcium. […] Diabetic ketoacidosis occurs in 4.68.0 per 1000 people with diabetes annually. […] Rates among those with type 1 diabetes are higher with about 4% in the United Kingdom developing DKA a year while in Malaysia the condition affects about 25% a year. […] The risk of death with adequate and timely treatment is between 1% and 5%. […] Up to 1% of children with DKA develop a complication known as cerebral edema.

• #21 Diabetic Ketoacidosis – Harvard Health

  https://www.health.harvard.edu/a_to_z/diabetic-ketoacidosis-a-to-z

  As blood ketone levels increase, the person’s breathing pattern may become slow and deep, and his or her breath can have a fruity odor. A person with ketoacidosis may seem to be tired or confused or may have trouble paying attention. Without prompt treatment in the first day of symptoms, the illness may cause low blood pressure, a loss of consciousness, coma or death. […] Symptoms of diabetic ketoacidosis can develop over a period of a few hours, and treatment results in rapid recovery. Commonly, people who develop ketoacidosis will remain in the hospital for one to three days.

• #22 Pediatric Diabetic Ketoacidosis (DKA): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/907111-overview

  Patients with diabetic ketoacidosis may also have the following signs and symptoms: Vomiting, Dehydration, Signs of intercurrent infection (eg, urinary or respiratory tract infection), Weakness and nonspecific malaise that may precede other symptoms of hyperglycemia, Tachycardia, Reduced capillary refill, Kussmaul breathing or deep sighing respiration – A mark of acidosis, Ketone odor – Patient may have a smell of ketones on his/her breath, Impaired consciousness – Occurs in approximately 20% of patients, Coma – May be present in 10% of patients, Abdominal tenderness – Usually nonspecific or epigastric in location. […] Most cases of cerebral edema occur 4-12 hours after initiation of treatment. […] Diabetic ketoacidosis is the most common cause of diabetes-related death in childhood. Without insulin therapy, the mortality rate is 100%, but current mortality rates are around 2-5%. […] Indeed, cerebral edema is the most important cause of mortality and long-term morbidity in patients with diabetic ketoacidosis.

• #22 Pediatric Diabetic Ketoacidosis (DKA): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/907111-overview

  Diabetic ketoacidosis (DKA) in children is defined as a blood glucose level of over 11 mmol/L (200 mg/dL), venous pH below 7.3 or serum bicarbonate level below 18 mmol/L, and either the presence of ketonemia (blood beta-hydroxybutyrate level 3 mmol/L) or moderate-to-high ketonuria. […] Symptoms of acidosis and dehydration include the following: Abdominal pain – May be severe enough to present as a surgical emergency, Shortness of breath – May be mistaken for primary respiratory distress, Confusion and coma in the absence of recognized head injury. […] Symptoms of hyperglycemia, a consequence of insulin deficiency, include the following: Polyuria – Increased volume and frequency of urination, Polydipsia – Thirst is often extreme, Nocturia and secondary enuresis in a previously continent child, Weight loss – May be dramatic due to breakdown of protein and fat stores, Muscle pains and cramps.

• #23 Diabetic Ketoacidosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0501/p1705.html

  Consciousness ranges from alert to confused to a comatose state in less than 20 percent of patients. […] Common complications of DKA include hypoglycemia, hypokalemia, and recurrent hyperglycemia. […] Cerebral edema is a rare but important complication of DKA. Although it can affect adults, it is more common in young patients, occurring in 0.7 to 1.0 percent of children with DKA. […] Early signs of cerebral edema include headache, confusion, and lethargy. […] Patients typically improve mentally with initial treatment of DKA, but then suddenly worsen. […] Once severe symptoms occur, the mortality rate is greater than 70 percent, and only about 10 percent of patients recover without sequelae.

• #24 Ketoacidosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534848/

  Patients with DKA may have a myriad of symptoms on presentation, usually within several hours of the inciting event. Symptoms of hyperglycemia are common, including polyuria, polydipsia, and sometimes more severe presentations include unintentional weight loss, vomiting, weakness, and mentation changes. Dehydration and metabolic abnormalities worsen with progressive uncontrolled osmolar stress, which can lead to lethargy, obtundation, and may even cause respiratory failure, coma, and death. Abdominal pain is also a common complaint in DKA. […] The initial laboratory evaluation of a patient with suspected DKA includes blood levels of glucose, ketones, blood urea nitrogen, creatinine, electrolytes, calculated anion gap, arterial blood gases, osmolality, complete blood count with differential, blood cultures and urine studies including ketones, urinalysis, urine culture, chest radiograph, and an electrocardiogram. Hyperglycemia is the typical finding at presentation with DKA, but patients can present with a range of plasma glucose values.

• #25 Diabetic ketoacidosis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/162

  Diabetic ketoacidosis (DKA) is characterised by a biochemical triad of hyperglycaemia (or a history of diabetes), ketonaemia, and metabolic acidosis, with rapid symptom onset. […] Common symptoms and signs include increased thirst, polyuria, weight loss, excessive tiredness, nausea, vomiting, dehydration, abdominal pain, hyperventilation, and reduced consciousness. […] DKA is an acute metabolic complication of diabetes that is potentially fatal and requires prompt medical attention for successful treatment. It is characterised by absolute or relative insulin deficiency and is the most common acute hyperglycaemic complication of type 1 diabetes mellitus. […] Key diagnostic factors include known diabetes or features of diabetes, nausea and/or vomiting, abdominal pain, dehydration, hyperventilation, reduced consciousness, presence of risk factors, and hypothermia. […] Other diagnostic factors include acetone smell on breath.

• #26 Diabetic ketoacidosis | nidirect

  https://www.nidirect.gov.uk/conditions/diabetic-ketoacidosis

  Diabetic ketoacidosis is a potentially life-threatening complication of diabetes caused by a lack of insulin in the body. It’s important to seek medical advice quickly if you think that you or your child is experiencing the condition. […] The initial symptoms of diabetic ketoacidosis can develop quite suddenly. They will continue to get worse if not treated. […] In the early stages, the main signs of diabetic ketoacidosis include: passing large amounts of urine, severe thirst, weight loss, feeling sick, tiredness, abdominal (tummy) pain, shortness of breath. […] Left untreated, more advanced symptoms can develop, including: rapid heartbeat (tachycardia), rapid breathing, where you breathe in more oxygen than your body actually needs (hyperventilate), vomiting, dizziness, a smell of ketones on your breath, which can smell like pear drops or nail varnish remover, confusion, drowsiness or loss of consciousness (coma). […] In some cases, life-threatening complications of diabetic ketoacidosis can also develop.

• #27 Diabetic Ketoacidosis – Hormonal and Metabolic Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/diabetes-mellitus-dm-and-disorders-of-blood-sugar-metabolism/diabetic-ketoacidosis

  Diabetic ketoacidosis is an acute complication of diabetes that occurs mostly in type 1 diabetes mellitus. […] Symptoms of diabetic ketoacidosis include nausea, vomiting, abdominal pain, and a characteristic fruity odor on the breath. […] Without treatment, diabetic ketoacidosis can progress to coma and death. […] The initial symptoms of diabetic ketoacidosis include excessive thirst and urination, weight loss, nausea, vomiting, fatigue, and particularly in children abdominal pain. Breathing tends to become deep and rapid as the body attempts to correct the blood’s acidity. The breath has a fruity odor similar to nail polish remover because of the smell of the ketones escaping into the breath. Without treatment, diabetic ketoacidosis can progress to coma and death (especially in children).

• #28 Diabetic Ketoacidosis (DKA): Symptoms, Causes, Treatment

  https://www.healthline.com/health/type-2-diabetes/ketoacidosis

  DKA occurs when insulin levels are low. Our bodies need insulin to use the available glucose in the blood. In DKA, glucose can’t get into the cells, so it builds up, resulting in high blood sugar levels. […] The most common causes of DKA are: missing an insulin injection or not injecting enough insulin, illness or infection, a clog in your insulin pump, if you use one. […] Risk factors for DKA include: having type 1 diabetes, being a younger age, as research suggests 63 percent of DKA cases happen in people below the age of 51, physiologic shock, emotional or psychological stress, acute cardiovascular disease, acute gastrointestinal illness, having an alcohol use or drug use disorder, having an eating disorder, certain endocrine conditions, recent surgery, pregnancy. […] Certain medications can increase the risk of DKA.

• #29 Understanding Diabetic Ketoacidosis: Symptoms, Causes, Treatment and M – Circufiber

  https://www.circufiber.com/blogs/diabetes-resources/diabetic-ketoacidosis?srsltid=AfmBOooseRVK0sZW90ayzRGPF7UiBWzY94eAH542xVIyvn_OkqPC2G7r

  Are you having sudden increased thirst, excessive urination or an odd fruity smell on your breath? These are signs of a life-threatening condition called Diabetic Ketoacidosis (DKA). […] It often occurs suddenly due mainly to excessive blood sugar levels, sometimes within 24 hours turning an otherwise good day into an urgent trip for help at the emergency room. […] Typically, various symptoms related to high blood sugar show up together that indicate one may have ketoacidosis dka. These include anything from dizziness, nausea/vomiting all the way down to shortness of breath as well as unusually sweet smelling breaths or even potential unconsciousness among others- making proper recognition paramount when dealing with diabetic ketoacidosis dka before things get serious! […] As the body searches for enough insulin to process glucose, certain signs point toward a possible diagnosis of diabetic ketoacidosis. Excessive urine is often among the first signs, increased thirst follows shortly after as more and more ketones are expelled in urine from breaking down fat stores for energy. Other symptoms may become evident such as nausea which can lead to vomiting or abdominal pains accompanied by a sweet odour on breath due to high concentrations of acid build up in blood. Weakness, fatigue and feeling drained also commonly appear at this stage with DKA wreaking havoc inside your body like an uninvited guest showing unwelcome effects everywhere it turns its attention towards.

• #30 Signs and Symptoms of Diabetic Ketoacidosis (DKA) – Children’s Health

  https://www.childrens.com/health-wellness/5-signs-and-symptoms-of-diabetic-ketoacidosis

  Diabetic ketoacidosis, or DKA, is a serious and potentially life-threatening complication of diabetes. Up to 70% of the time, when a child is first diagnosed with diabetes, it’s because they are experiencing DKA. […] Signs and symptoms of DKA include frequent urination, increased thirst, increased hunger, unexplained weight loss and flu-like symptoms. […] DKA is a serious condition. Always seek medical attention from your pediatrician or another medical professional if your child has the above symptoms. Early recognition can help lessen the severity of DKA in a child and possibly save a child’s life.

• #31 Diabetic Ketoacidosis (DKA): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/118361-overview

  The prognosis of properly treated patients with diabetic ketoacidosis is excellent, especially in younger patients if intercurrent infections are absent. The worst prognosis usually is observed in older patients with severe intercurrent illnesses (eg, myocardial infarction, sepsis, or pneumonia), especially when these patients are treated outside an intensive care unit.

• #32 Euglycemic diabetic ketoacidosis: a potential pitfall for the emergency physician

  https://www.ceemjournal.org/journal/view.php?doi=10.15441/ceem.22.410

  Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus that can occur in patients with type 1 or type 2 diabetes. The triad of hyperglycemia, metabolic acidosis with an increased anion gap, and ketosis heralds the familiar clinical presentation of DKA. […] Patients with eu-DKA typically present with symptoms such as malaise, dyspnea, nausea, vomiting, and abdominal pain, similar to patients with conventional DKA. […] The most important step in diagnosis of eu-DKA is considering it as an option and not being falsely reassured by the presence of normoglycemia. […] A patient with eu-DKA will typically have normoglycemia in the presence of metabolic acidosis (pH less than 7.3) and decreased blood bicarbonate (less than 18 mmol/L). […] For an unsuspecting emergency physician, eu-DKA is a diagnostic challenge, primarily due to the absence of hyperglycemia. Understanding the various mechanisms that lead to eu-DKA and the various contexts in which it can occur, particularly the at-risk groups, will increase consideration of eu-DKA as a potential diagnosis. […] Treatment focuses on aggressive hydration, glucose replacement, insulin administration, and correction of any electrolyte imbalance, as well as treating the precipitating cause. Morbidity and mortality can be significantly improved by early diagnosis and initiation of treatment.

• #33 Diabetic ketoacidosis (DKA) | Ketosis symptoms and treatment | Diabetes UK

  https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/complications/diabetic-ketoacidosis

  Diabetic ketoacidosis, known as DKA, is a life-threatening diabetes complication. It is caused by a severe lack of insulin. Without insulin your body cant move sugar into the cells for energy so instead breaks down fat releasing harmful chemicals called ketones which build up and make your blood acidic. […] A large build-up of ketones can lead to you becoming seriously ill very quickly. […] DKA is more likely to happen to someone with type 1 diabetes, someone with any type who uses insulin, and people taking SGLT2 inhibitors, but can happen to other people on tablets or without a diagnosis too. […] It is important to be able to spot the signs and symptoms of DKA so that it can be treated quickly. […] DKA is diagnosed in hospital with a blood test. These are the signs and symptoms: […] Symptoms of DKA can include: being very thirsty, needing to wee more often, feeling tired and sleepy, confusion, blurred vision, stomach pain, feeling or being sick, sweet or fruity-smelling breath, like nail polish remover or pear drop sweets, passing out.

• #34 Adult Diabetic Ketoacidosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560723/

  The most important cause of mortality is cerebral edema, usually seen in younger patients. The cerebral edema is primarily due to the intracellular shifts. Another important cause of morbidity is renal dysfunction. A recent study has noted that among patients with type-2 diabetes mellitus who develop DKA, there is a high risk of stroke within the first six months after the event.

• #35 Ketoacidosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534848/

  After the initial stabilization of circulation, airway, and breathing as a priority, specific treatment of DKA requires correction of hyperglycemia with intravenous insulin, frequent monitoring, and replacement of electrolytes, mainly potassium, correction of hypovolemia with intravenous fluids, and correction of acidosis. Given the potential severity and the need for frequent monitoring for intravenous insulin therapy and possible arrhythmias, patients may be admitted to the intensive care unit. Blood glucose levels and electrolytes should be monitored on an hourly basis during the initial phase of management.

• #36 Diabetic ketoacidosis | healthdirect

  https://www.healthdirect.gov.au/diabetic-ketoacidosis

  Most people with DKA need hospital treatment in an intensive care unit (ICU). […] DKA is a serious condition. The treatment is complex, and you will need to be watched carefully to reduce your risk of complications, such as: low potassium levels in your blood, hypoglycaemia (low blood glucose levels), cerebral oedema (brain swelling), pulmonary oedema (fluid in your lungs).

• #37 Diabetic Ketoacidosis Causes, Symptoms, Treatment, Recovery

  https://www.medicinenet.com/diabetic_ketoacidosis/article.htm

  Diabetic ketoacidosis has a high mortality (death rate) and risk of complications. The prognosis depends on how quickly it is recognized, the underlying medical conditions of the individual, and the underlying precipitating causes of diabetic ketoacidosis. […] Because many people who develop diabetic ketoacidosis have multiple underlying illnesses (besides diabetes) diabetic ketoacidosis can lead to significant complications and death. Cardiac arrest and kidney failure are all known complications.

• #38 Diabetic ketoacidosis (DKA) | Ketosis symptoms and treatment | Diabetes UK

  https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/complications/diabetic-ketoacidosis

  If you spot any of these symptoms it is a sign that you need to get some medical help quickly. […] The early signs of DKA can often be treated with extra insulin and fluids if it is picked up quickly. But if it isnt, DKA needs urgent hospital treatment and can be life-threatening. […] Treatment of DKA includes: being given insulin through a vein, being given fluids through a vein to rehydrate your body, being given nutrients through a vein to replace any you’ve lost. […] You’ll also be closely monitored to make sure there are no serious problems with your brain, kidneys, heart or lungs. […] You can help avoid DKA by monitoring your blood sugar levels regularly and altering your insulin dose in response to your blood sugar levels and what you eat. […] Your blood sugar levels could be higher than normal when you are unwell, putting you at risk of DKA.

• #39 Diabetic Ketoacidosis (DKA) – Endocrinology Advisor

  https://www.endocrinologyadvisor.com/ddi/diabetic-ketoacidosis-dka/

  Diabetic ketoacidosis (DKA) is characterized by the presence of metabolic acidosis, ketonemia, and hyperglycemia. With prompt treatment, most patients with DKA recover, but in rare cases, such as patients who develop cerebral edema or have an underlying illness, DKA can become life-threatening. […] Most patients with DKA will present with symptoms typical of hyperglycemia, including polydipsia and polyuria. More severe symptoms include weight loss, weakness, abdominal pain, vomiting, headache, and confusion or other cognitive changes. If left untreated, dehydration and electrolyte abnormalities develop. […] Upon examination, patients often demonstrate physical findings consistent with dehydration, such as tachycardia, hypotension, dry mucous membranes, poor skin turgor, and sunken eyes. Another characteristic symptom is a rapid and deep breathing pattern known as Kussmaul breathing. People with DKA often have fruity-smelling breath due to the acetone in their body and may exhibit changes in mental status. Many patients with DKA experience nausea, vomiting, or abdominal pain.

• #40 What Is Diabetic Ketoacidosis? DKA Symptoms & Signs

  https://www.emedicinehealth.com/diabetic_ketoacidosis/article_em.htm

  Diabetic ketoacidosis (DKA) results from dehydration during a state of relative insulin deficiency, associated with high blood levels of sugar level and organic acids called ketones. Diabetic ketoacidosis usually occurs in people with type 1 (juvenile) diabetes mellitus (T1DM), but diabetic ketoacidosis can develop in any person with diabetes. […] The warning signs and symptoms of diabetic ketoacidosis may be one or more of these symptoms, vomiting, excessive thirst, confusion, abdominal pain, and dry skin. […] A person with diabetes developing diabetic ketoacidosis may have one or more of these symptoms excessive thirst or drinking lots of fluid, frequent urination, general weakness, vomiting, loss of appetite, confusion, abdominal pain, shortness of breath, a generally ill appearance, and dry skin or mouth, increased heart rate, low blood pressure (hypotension), increased rate of breathing, and a distinctive fruity odor on the breath. […] With aggressive treatment, most people who develop diabetic ketoacidosis can expect complete recovery. Death is rare (2% of cases), but can occur when the condition is not treated.

• #41 Diabetic Ketoacidosis (DKA) – Endocrinology Advisor

  https://www.endocrinologyadvisor.com/ddi/diabetic-ketoacidosis-dka/

  Many people with DKA are treated in an emergency department before being admitted to an intensive care unit, but most recover. Although the prevalence of DKA has increased, the mortality rate has decreased to less than 5%. However, timely follow-up with a physician after discharge is necessary, because 40% of patients are readmitted within 2 weeks of discharge.

• #42 Diabetic Ketoacidosis (DKA): Symptoms, Causes, Treatment

  https://www.healthline.com/health/type-2-diabetes/ketoacidosis

  If left untreated, DKA can lead to a coma or death. […] If you have type 1 diabetes and have a blood sugar reading of over 240 milligrams per deciliter (mg/dL), you should test yourself for ketones using a urine or blood test. […] Call your doctor if moderate or high levels of ketones are present. Always seek medical help if you suspect you are progressing to DKA. […] People with type 2 diabetes are usually at lower risk of DKA. But the risk can increase when your body is under strain due to injury, infection, or surgery. […] If you have any of the following symptoms, and you can’t reach your doctor, the Centers for Disease Control and Prevention (CDC) recommends getting emergency help right away: a blood sugar level that stays at 300 mg/dL or higher, breath that smells fruity, severe vomiting, where you can’t keep food or drinks down, difficulty breathing, multiple symptoms of DKA.

• #43 Busting myths about diabetic ketoacidosis, a common but serious complication of diabetes

  https://health.ucdavis.edu/news/headlines/busting-myths-about-diabetic-ketoacidosis-a-common-but-serious-complication-of-diabetes/2021/08

  Early signs of DKA include excessive thirst, frequent urination, nausea, abdominal pain, weakness and confusion. […] Signs of DKA that suggest a medical emergency needing immediate treatment include: vomiting/cant keep food or drinks down, trouble breathing, confusion or lethargy, multiple signs and symptoms of DKA. […] DKA happens when diabetes goes undiagnosed or is poorly managed. […] There is an opportunity to avoid DKA with proper management of glucose levels in the blood. […] When a patient presents to the Emergency Department with DKA symptoms, we work on replacing the lost fluids and electrolytes due to frequent urination and vomiting. We give the patient the needed insulin to reduce blood glucose levels and resolve ketosis.

• #44 Diabetic ketoacidosis (DKA): symptoms, prevention and management | Dexcom

  https://www.dexcom.com/en-us/all-access/clinical-corner/diabetic-ketoacidosis-symptoms-prevention-and-management

  DKA is a serious, life-threatening condition that occurs when the body has a lack of insulin and elevated glucose. […] Common symptoms of DKA include but are not limited to: Thirst/dry mouth, Frequent urination, High glucose levels/high glucose levels for an extended period, High ketone levels, Dry/flushed skin, Abdominal pain, nausea, vomiting, Difficulty breathing, Fruity-smelling breath, Confusion. […] If you feel sick, „off” or unlike yourself and your normal/usual efforts to get your glucose into range do not work or if your ketones levels are moderate or high, contact your healthcare provider for recommendations and/or treatment. […] Seek emergency care when your glucose is higher than 300 (mg/dL) for more than one test, you have ketones in your urine and you cant get in touch with your healthcare provider, or you have DKA symptoms, including excessive thirst, frequent urination, nausea and vomiting, abdominal pain, fatigue, difficulty breathing, fruity-smelling breath, and/or confusion. […] Remember, DKA is a serious, life-threatening condition with symptoms you should not ignore. Delaying action to address high ketone levels puts your life in jeopardy.

• #45 Signs and Symptoms of Diabetic Ketoacidosis | Complete CareChevron downChevron downChevron downFacebookLinkedinDirectionsArrow rightArrow rightArrow rightArrow rightArrow rightArrow rightArrow rightArrow rightFacebookYoutubeLinkedinInstagram

  https://www.visitcompletecare.com/blog/signs-and-symptoms-diabetic-ketoacidosis/

  Call your doctor or go to the emergency room immediately if you are experiencing high or moderate ketones in conjunction with symptoms including: Stomach pain, Fruity breath, Blood sugar levels remain at 300mg/dL or above and are not responding to at-home treatment, Vomiting for 2+ hours, Exhaustion, confusion, or dizziness, Shortness of breath. […] When there are too many ketones, these high levels can become poisonous and need to be treated immediately.

• #46 All About Diabetic Ketoacidosis (DKA) | Beyond Type 1

  https://beyondtype1.org/all-about-dka/

  Diabetic ketoacidosis (DKA) is a serious, life-threatening diabetes complication. It often occurs at type 1 diabetes diagnosis, mistaken for flu. DKA arises when the body lacks insulin to process glucose, breaking down fat instead and releasing ketones. Symptoms include severe thirst, weight loss, blurry vision, and disorientation. […] Elevated ketones in the urine, severe weight loss, extreme thirst, blurry vision, lethargy, and disorientation are all signs of DKA. […] If left untreated, DKA will lead to coma and death.

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