Diabetic Ketoacidosis

GENERAL INFORMATION:

What is it?

• Diabetic (di-uh-bet-ik) ketoacidosis (key-toe-ass-ih-doe-sis) is also called "DKA." It is a serious problem in people with diabetes (di-uh-b-tees) mellitus (meh-lih-tus). DKA happens when your blood sugar gets very high and is not treated properly.
  
  
• Much of what you eat and drink is changed into sugar (glucose). Sugar gives you energy. Insulin makes your body use this sugar and helps keep your blood sugar normal. With diabetes mellitus, your body does not make enough insulin or your body does not respond normally to insulin. Without insulin, sugar builds up in the blood.
  
  
• With diabetes, sugar stays in your blood and is not changed into energy. Your body must now use fat for energy. When this happens, chemicals called ketones are left in your blood. Your blood sugar will keep getting higher if you do not get enough insulin. Ketones build up in your blood and cause body cells to be damaged. This makes you very sick and you can even die.

Causes: DKA can come on slowly or happen very quickly. Some of the main causes are:

• Not getting enough insulin.
  
  
• Missing a dose of insulin.
  
  
• Illness, such as pneumonia (new-moan-yuh).
  
  
• Infection (in-fek-shun), such as a urinary tract infection.
  
  
• New diagnosis of diabetes.
  
  
• Diabetes that is not being treated.
  
  
• Stress.
  
  
• Injury.

Signs and Symptoms:

• Early signs and symptoms of DKA:
  
  
  • Fast, deep breathing.
    
    
  • High blood sugar.
    
    
  • Vomiting (throwing up).
    
    
  • Weakness.
  
  
• Later signs and symptoms of DKA:
  
  
  • Abdominal pain.
    
    
  • Chest pain.
    
    
  • Confusion.
    
    
  • Dry mouth.
    
    
  • Fruity-smelling breath.
    
    
  • Fullness in abdomen (belly).
    
    
  • Headache.
    
    
  • Hungrier than usual.
    
    
  • Nausea (upset stomach).
    
    
  • Tiredness or sleepiness.
    
    
  • Thirstier than usual.
    
    
  • Urinating (going to the bathroom) more than usual.
    
    
  • Weight loss.
    
    
  • Coma (unable to be woke up from sleeping).

Care:

• DKA can be treated and controlled most of the time. But early treatment is very important. Call your caregiver when you see or feel any signs of DKA. Check your blood sugar and urine ketone levels as often as your caregiver tells you to. Check your blood sugar more often when you are sick. Ask your caregiver for the CareNotes™ handouts explaining how to do these tests if you don't know.
  
  
• You may need to be put in the hospital for tests and treatment. You may need to have an EKG, blood tests, x-rays, and have an IV. The dose or type of medicine that you take for diabetes may have to be changed. Your diet may have to change, and your urine and blood checked often. Ask your caregiver for information about DKA to help you understand about the different tests and treatments.

Medical Alert Bracelet or Necklace: Make sure you wear a medical alert bracelet or necklace saying that you have diabetes. You may get one from your local drugstore or contact the MedicAlert Foundation listed below:

• MedicAlert Foundation
  2323 Colorado Avenue
  Turlock, CA 95382
  Phone: 1-888-633-4298
  Web Address: http://www.medicalert.org
  

Support:

• Diabetes is a life-changing disease for you and your family. Accepting that you have diabetes is hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. Let them help you. Encourage those close to you to talk to your caregiver about how things are at home. Your caregiver can help your family better understand how to support a person with diabetes.
  
  
• You may also want to join a support group. This is a group of people who also have diabetes. Ask your caregiver for the names and numbers of support groups in your town. Or, you can contact the following organizations for more information:

• American Diabetes Association
  1701 North Beauregard Street
  Alexandria, VA 22311
  Phone: 1-800-342-2383
  Web Address: http://www.diabetes.org
  

• Juvenile Diabetes Research Foundation International
  120 Wall Street
  New York, NY 10005-4001
  Phone: 1-800-533-2873
  Web Address: http://www.jdf.org
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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