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Diabetic Ketoacidosis - Medical Negligence
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Diabetic ketoacidosis is a diabetic complication in which the body makes high levels of ketones-blood acids that come when the body has become damaged from high blood sugar. It can happen when you have too little insulin in the body or when the body is extremely resistant to insulin. It is mostly a disease of type I diabetes but can rarely be found in type II diabetes. The body breaks down fats as a way to make fuel but ketones are the byproduct of this process.
Diabetic ketoacidosis has warning signs that every diabetic should be aware of. These include having excessive thirst, nausea and vomiting, excessive urination, abdominal pain, loss of appetite, tiredness or weakness, fruity scent to the breath, shortness of breath and confusion.
If you have home monitoring of diabetes, the blood sugar level will be revealed as very high and there will be ketones showing up in the urine. You should see the doctor if you have symptoms of diabetic ketoacidosis and have a seriously high blood sugar unresponsive to the home remedies you have at home. Moderate to high ketones in your urine should prompt a visit or call to the doctor.
Untreated diabetic ketoacidosis can be fatal if left without proper treatment so you should seek emergency treatment if your symptoms and blood sugar are severe.
The causes of diabetic ketoacidosis are many. You can have diabetic ketoacidosis from being ill with a viral or bacterial illness that stresses the body. It can affect the amount of epinephrine in your system-a hormone that can work against your body's insulin. Pneumonia and UTIs are common infections that can trigger diabetic ketoacidosis. If you miss your insulin doses too many times, you can rapidly go into diabetic ketoacidosis and can have problems with the above symptoms.
Other triggers consistent with getting diabetic ketoacidosis include emotional or physical trauma, severe stress, high fever, heart attack, surgery, alcohol use, drug use or stroke. You are at highest risk if you have type I diabetes and are under the age of 19 years. Sometimes diabetic ketoacidosis can be the first sign that you have diabetes of some type, including type I, type II and gestational diabetes.
The treatment of diabetic ketoacidosis includes giving a lot of fluids, providing electrolytes, including sodium, chloride and potassium. Managing low blood sugar should it occur. Your blood sugar can plummet during the treatment of ketoacidosis and this needs to be managed as well. Low potassium needs to be treated specifically as this is a common complication of diabetic ketoacidosis. Cerebral edema or brain swelling is a complication of changing the electrolytes and sugar too fast in the system and must be watched out for.
Blood testing for ketoacidosis involves checking the level of sugar in the blood, checking the level of ketones in the blood and urine and determining the blood acidity, which will be low in diabetic ketoacidosis. Blood gases can determine this level of blood acidity. Electrolytes should be evaluated as well as a urinalysis, chest x-ray and EKG to check the function of the heart in the presence of abnormal electrolytes.
The three main focuses of the treatment of diabetic ketoacidosis include the following steps:
- Replacing fluid. IV or oral fluid replacement is done because the individual is usually quite dehydrated in the presence of an elevated sugar and ketone level.
- The electrolytes need replacing. These include replacing sodium, potassium and calcium, which have been lost through the kidneys. This is usually done by putting these substances in IV fluids.
- Insulin must be used in order to bring down the blood sugar. Insulin is given by IV in order to get the blood sugar down as safely as possible.