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Diabetic acidosis (ketoacidosis)

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Diabetic acidosis (ketoacidosis)

Reviewed by Professor Ian W Campbell, consultant physician and Dr Soon Song, consultant physician

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Diabetic acidosis is a life-threatening condition that can occur in people with Type 1 diabetes. Less commonly, it can also occur with Type 2 diabetes.

Ketones: breakdown products from the use of fat stores for energy.

Ketoacidosis: another name for diabetic acidosis.

What causes diabetic acidosis?

The condition is caused by a lack of insulin, most commonly when doses are missed.

While insulin's main function is to lower the blood sugar level, it also reduces the burning of body fat.

If the insulin level drops significantly, the body will start burning fat uncontrollably while blood sugar levels rise.

Glucose will then begin to show up in your urine, along with ketone bodies that turn the body acidic.

The body attempts to reduce the level of acid by increasing the rate and depth of breathing. This blows off carbon dioxide in the breath, which tends to correct the acidosis temporarily.

At the same time, the high secretion of glucose into the urine causes large quantities of water and salts to be lost, putting the body at serious risk of dehydration.

Eventually, over-breathing becomes inadequate to control the acidosis.

What are the symptoms?

Since diabetic acidosis is most often linked with high blood sugar levels, symptoms are the same as those for diabetes:

increased thirst

increased urination

tiredness

confusion

possible loss of consciousness.

Symptoms of the acidosis are:

fast, deep breathing

a smell of acetone on your breath

nausea and vomiting

stomach pains.

Diabetic acidosis is often triggered by an infection, such as a urine or chest infection. It can develop in anything from a matter of hours to a few days.

How can I prevent diabetic acidosis?

Good advice During serious illness more insulin is almost always necessary - especially if you have an infection with fever.

For this reason, make sure you measure your blood sugar level if you are ill.

If the level is high, take extra insulin.

But be careful not to take so much as to increase your risk of a hypo.

Gastritis and diabetic acidosis

Diabetic acidosis can often happen as a result of a stomach infection (gastritis).

This is because the symptoms of gastritis - nausea, vomiting and reduced eating - make you think less insulin is needed. And insufficient amounts of insulin can quickly lead to diabetic acidosis.

How do I know if I have diabetic acidosis?

The diagnosis is made by:

measuring your blood glucose level - this is usually in double figures and may be very high

measuring the level of ketones in your urine. If they are present in moderate or heavy amounts, ketosis is present and acidosis is likely to occur.

a blood sample taken from an artery - this is done in hospital and accurately measures the acidity of the blood.

At the same time, the doctor will look for the presence of an infection.

How is diabetic acidosis treated?

Exercise Because exercise can help diabetes, some people think it will help the symptoms of acidosis.

In fact, exercise only makes things worse.

Diabetic acidosis is caused by a low insulin level and must be treated with insulin.

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