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Medically Verified By: Dr Snehal Tanna - Consultant Diabetologist Jupiter Hospital Thane.
Delayed Diabetic Ketoacidosis Treatment: Warning Signs Your High Blood Sugar Levels Are Dangerously Out of Control
Diabetic keto-acidosis (DKA) is an acute complication in patients with diabetes resulting from consistently high glucose levels in the blood. This complication is commonly seen in Type 1 diabetics (the ones who do not produce insulin at all and require to be on subcutaneous insulin shots for life) but can also manifest in Type 2 diabetics (who do produce insulin and usually require oral medications to control their diabetes). The commonest reason for this complication is the missing/skipping of insulin shots, especially in Type1 diabetics, but also in some Type diabetics on insulin. Other common reasons for the development of this problem are the presence of infection, stress (physical or mental), severe dehydration, and non-monitoring of self glucose resulting in increased levels of glucose going unnoticed. Type 1 diabetics are usually detected for the first time presenting with DKA.
Diabetic keto-acidosis requires prompt management that might include admission to the hospital in order to prevent any serious or life-threatening medical complications. Prompt management mainly involves recognizing early symptoms and assessing the severity so that immediate medical attention is sought.
As the name suggests, DKA involves (DIABETIC) high blood glucose levels, (KET0nes) presence of by-products of fat breakdown due to either lack of insulin or inability of insulin to function resulting in high levels of (ACIDosis). This condition results in impaired functions of critical organs including, kidneys, heart, brain, etc., and if not managed in time results in coma or death. DKA may progress rapidly and hence recognising early symptoms and seeking immediate medical attention is the key to reducing the severity of this complication. High blood glucose levels, usually above 250mg%, for a long duration result in increased urination (the body's protective mechanism to throw away excess glucose) followed by or accompanied by intense thirst. As the ketone levels increase, there might be severe abdominal pain/cramps with severe nausea and vomiting, further causing dehydration. As dehydration progresses, headaches, confusion, and lethargy may occur that might progress to coma. If untreated, the breathing becomes short and heavy with a fruity odor, as the body tries to reduce its acid levels.
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To avoid DKA, the key is to regularly monitor blood glucose. Monitoring your blood glucose levels may warn you of increasing trends before they are risky and indicate the need to seek medical attention. If the glucose levels are above 250mg% consistently in spite of dose adjustments, you should consult with the treating physician.
Adhering to your insulin schedule is essential; do not omit insulin injections (even if there is nausea, vomiting, or loose motions) unless you consult your doctor. Keep monitoring glucose levels frequently (usually every hour) on the home glucometer and adjust food/liquid intake as per the glucose levels.
Drinking plenty of water makes it easier for your body to pass out excess glucose and ketones. When your blood sugar is consistently elevated, you can test your urine or blood with ketone test strips to see if there are ketones. If you have several of the symptoms of DKA, don't wait to go to the emergency room or call your physician.
If you or someone around you exhibits symptoms of DKA, prompt action is essential. Take a blood sugar and ketone test; if the readings are high and there are ketones, seek medical attention right away. Stay hydrated by drinking plenty of water to dilute the excess blood sugar until you can get medical attention. DKA is an emergency, and delay can quickly escalate the situation and lead to complications. By learning the warning symptoms and responding urgently, you may be able to minimize the chance of serious consequences.