“Who is at risk of ketoacidosis?”

Keto acid is a serious event in patients with type1 diabetes (insulin dependent diabetes). It is associated with some illness and not taking the needed insulin. Does not occur in type 2 diabetes.

I rarely have patients with diabetic ketoacidosis. It is not common, it is found in Type 1 diabetics usually but can be found in Type 2 diabetics who are insulin deficient, have had diabetes for a long time or have diabetes out of control. Diabetic ketoacidosis comes from insulin deficiency. Sugar cannot enter the cell, thus it is starving. Then fat breaks down quickly and ketones are made. These are acid particles.

Ketoacidosis is a dangerous condition where the body starved of its insulin signal shifts to burning fat as emergency fuel generating ketones as byproducts. These substances in excess generate an acid environment in the blood which causes nausea, vomiting, lethargy and other problems. Untreated in this situation the patient with diabetes may die. Treatment is with intravenous fluids (salt water, potassium) and insulin. The best approach is prevention. Patients with diabetes requiring insulin should monitor their blood glucose and make sure that they are giving insulin in the correct amount for every situation. A specialist will provide detailed instructions and be available for emergencies.

Two groups of people are at risk of DKA. People with Type 1 diabetes are the main group at risk since they have little or no insulin except what they get from outside. DKA may be produced by errors in dosing (skipping a dose or doses a common trick of teen agers) or by stresses such as infection that increases need. DKA can also occur in Type 2 diabetes mainly in people taking the new drugs in the class of SGLII drugs. These drugs block the reabsorption of sugar out of the urine causing the excretion of the sugar but that also takes water with it so 5they can become dehydrated especially on a hot day suck as today or if they become ill and cannot drink enough. In that case the dehydration causes changes in the liver and ketones are produced. If not corrected DKA is the result. Occasionally Type 2 diabetes can be so severe due to loss of insulin secretion that they will react like a Type 1 when stressed or miss meds & go into DKA. This problem is usually preventable and if it becomes a problem the cause should be looked for & corrected. DKA should rarely be fatal though it continues to be. I have practiced diabetes for 55 years and have never lost a pt. in DKA who was not already pretty far gone when I got them. Find the cause 7& CORRECT IT and have not fear. It can be taken care of.