Diabetic ketoacidosis is one of acute complications of Diabetes mellitus which occurs due to the levels of glucose in the blood is very high.
The situation is a serious condition that can be life-threatening. Condition of ketoacidosis can occur anytime, especially in people with Diabetes mellitus type 1.
Unlike Diabetes mellitus type 1, on of Diabetes mellitus type 2, ketoacidosis occurs in certain circumstances. This is because usually people with Diabetes mellitus type 2 is more frequently experienced Nonketotic non ketotik.
Cover the onset diabetic ketoacidosis starts from patuhnya not diabetesein at a predetermined diet pattern.
In addition, diabetic ketoacidosis often triggered by the lack of the diabetesein to perform the examination of blood glucose levels and urine sugar levels at regular intervals.
The symptoms first occurred just as the symptoms of untreated Diabetes mellitus. Namely, dry mouth, thirst, urination so intensity more often (poliuria). Other symptoms such as nausea, vomiting, and abdominal pain may also occur.
Later symptoms may include difficulty breathing, feeling like a dehydrated, sleepy and taste the most severe coma.
Cause diabetic ketoacidosis
The cause of the occurrence of Ketoacidosis are associated with hormone levels of insulin in the blood is low. Blood levels of insulin in the form of low blood glucose levels cause being high.
Hormone insulin needed in the process of absorption of nutrients so that sugar can enter into a cell to be distributed throughout the body to be used as an energy source. The hormone insulin also helps keep up the fat in the fat cells from the results of digestion of food.
When the levels of the hormone insulin in the blood is low, then the present sugar can’t get into the cells to be processed into a source of energy. If so, the body will mengkompensasikannya with how to use fat as a source of alternative energy.
But due to the use of fat can not be burned, it will be perfectly produced a substance called ketone bodies. Ketone bodies accumulate in the blood and will be expelled from the body through urine.
There is a ketone bodies in the urine called ketonuria. High blood glucose levels will cause simply applied in the urine increased. Increased urine glucose levels will cause increased urine volume so that the fluid in the body is reduced.
Symptoms of diabetic ketoacidosis
When the condition of the body experience dehydration, then it will cause the symptoms of thirst and dry mouth which is the typical signs of high blood glucose levels.
The onset of dehydration and the formation of ketone bodies make the blood becomes more acidic. State of the blood becomes more acidic called Ketoacidosis.
In severe cases where dehydration that occurs is very great and hormone levels of insulin in the blood is very low, sufferers of Diabetes mellitus can have commas. Where a person in a coma is a State of emergency that requires patients to immediately taken to hospital to be given the help they deserve.
The process of the occurrence of a comma in diabetic ketoacidosis is more gradual than the onset of a coma hypoglycemia. State of diabetic ketoacidosis requires immediate medical treatment, so patients must be quickly taken to hospital.
Diabetic ketoacidosis symptoms often develops quickly, sometimes within 24 hours. For some of the signs and symptoms may be an indication of diabetes. You know, Diabetic Ketoacidosis is one of acute complications of Diabetes mellitus that occurs because the levels of glucose in the blood is very high. The general pattern that happens, patients suffering disobedient from diabetic ketoacidosis diet patterns that have been set.
Symptoms of diabetic ketoacidosis include:
- Excessive Thirst
- Frequent urination
- Nausea and vomiting
- Abdominal pain
- Weakness or fatigue
- Shortness of breath
More specific that can be detected through a blood test and urine at home include:
- High blood sugar levels (hyperglycemia)
- High levels of ketones in the urine
Disorders of glucose metabolism in diabetic ketoacidosis symptoms have signs:
- Hyperglycemia (blood glucose during > 300 mg/dL),
- Hiperketonemia/ketonuria and metabolic acidosis (blood pH of 7.3 and bicarbonate blood < < 15 mEq/L)
Diabetic ketoacidosis divided based on the level of asidosisnya:
- Lightweight: blood pH of 7.3, plasma bicarbonate < < 15 mEq/L
- MEDIUM: blood pH 7.2, plasma bicarbonate < < 10 mEq/L
- Weight: blood pH, plasma bicarbonate 7.1 < < 5 mEq/L
Administering Insulin in diabetic ketoacidosis:
- Insulin can only be given after the shock fluid resuscitation with resolved.
- Insulin used is a type of Short-acting/Rapid Insulin (RI).
- in the 60-90 minutes early hydration, can occur even if blood sugar levels decrease insulin has not been given.
- The dose used is 0.1 units/kg/day or 0.05 units/kg/h in children < 2 years.
- Administering insulin syringe pump with preferably within 0.1 unit/ml dilution or when no syringe pump can be done with microburet (50 units in 500 mL NS), separate from the liquid rumatan/hydration.
- Decrease in blood glucose levels is expected is 70 to 100 mg/dL/hour.
- when blood glucose reached 200-300 mg/dL, replace rumatan with fluid D5 ½ copy.
- the expected blood glucose levels is 150-250 mg/dL (target).
- when blood glucose < 150 mg/dL or his descent too soon, replace the liquid with the D10 ½ copy.
- If the blood glucose remains below the target of lowering the speed of insulin.
- do not stop the insulin or reduce to 0.05 unit </kg/h.
- Provision of continuous insulin and glucose feeding still needed to stop to ketosis and induce anabolism.
- At the time of clinical improvement does not occur, do the laboratoris/re-assessment of the condition of the patient, giving insulin, consider the cause of the failure response giving insulin.
- In the case of the IV line unavailable, give insulin to the subcutaneous or intramuskuler. An ugly chain perfusion will inhibit the absorption of insulin.
If you experience signs and symptoms of diabetic ketoacidosis such as the above, chances are you’re suffering from diabetic ketoacidosis. Immediately contact your doctor or nearest hospital