4.2 Diabetic ketoacidosis (DKA)

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Diabetic ketoacidosis (DKA) is a medical emergency in persons with diabetes. It is commonly found in T1DM but it also occurs in other types of diabetes during stressful situations. It results from lack of insulin and an increase in counter-regulatory hormones that lead to hyperglycemia and subsequent lipolysis.

4.2.1 Precipitating factors

• Intercurrent Infection
• Discontinuation of insulin therapy
• Inadequate insulin therapy
• Pancreatitis, myocardial infarction, cerebrovascular accident, pulmonary embolism
• Stressful conditions like trauma, pregnancy
• New-onset T1DM

4.2.2 Clinical features

• Develops rapidly (hours to days).
• Symptoms of uncontrolled diabetes precedes.
• Dehydration is the most obvious clinical feature with dry skin and tongue, low BP, rapid weak pulse.
• Acidotic breathing is characteristic; there may be acetone smell in breath.
• Weakness, vomiting, impairment of level of consciousness, acute abdomen.