Today we consider such a common complication of diabetes as ketoacidosis. What it is? What are the causes and principles of treatment? How to prevent the development of the disease? We discuss these issues in the article.
General information
The main reason for the development of this pathology is insulin deficiency, as a result of this, the blood glucose level rises and urine is formed intensively. Which leads to dehydration, loss of salts, and breakdown of fats. In the process of fat breakdown, ketones are produced - special substances that can increase the acidity of the blood. Ketoacidosis is a disease that has an acute course and develops very quickly. In some cases, this pathology is the first sign of type 1 diabetes .
Causes
A disease can develop as a result of:
Incorrect calculation of insulin dose or skipping injection.
Infectious intoxication.
Serious violations in the usual diet.
Late diagnosis.
Changes in the need for insulin, which can be caused by the production of growth hormone, surgical intervention, a change in the usual rhythm of life, stress.
Inadequate self-control in food.
Ketoacidosis: symptoms of the disease
Excessive ketone bodies adversely affect the body, and over time signs of poisoning appear. If ketoacidosis develops, pathology symptoms are expressed as:
nausea
vomiting
often occurring abdominal pain, sometimes very pronounced;
weight loss;
the appearance of deep, noisy, frequent breathing;
headache, dizziness;
drowsiness, lethargy.
Also, with such an ailment, weak cramps of the extremities appear, the smell of acetone from the mouth, the skin becomes excessively dry, there is a complete or partial loss of orientation in space.
An objective indicator of ketoacidosis is the presence of acetone in the urine, which is easily determined using special test strips.
Finding one or more symptoms requires specialist advice.
Diagnostics
In order to diagnose ketoacidosis, certain studies are needed. These include:
General inspection.
Analysis of medical history and patient complaints.
Laboratory studies, including:
blood glucose analysis;
general analysis of blood and urine;
determination of the presence of ketone bodies in the blood:
urine analysis for acetone and ketone bodies;
determination of the presence of ions in the blood (potassium, sodium), creatinine, urea, chlorides, lactate, bicarbonate levels;
analysis of the acid-base ratio of blood and gas composition.
Ketoacidosis: treatment of pathology
This ailment requires immediate medical attention. With a disease such as ketoacidosis, treatment consists primarily in restoring potassium and water balance in the patient's body. It is also extremely important to reduce the amount of sugar (to normal values) and blood acidity.
Treatment of ketoacidosis in diabetes mellitus includes such measures:
Short-acting insulin (a hormone that helps lower blood glucose) is injected intravenously and the blood glucose is monitored hourly.
Sodium chloride solutions (in various concentrations) make up for the liquid deficiency.
To prevent hypoglycemia (a condition in which the blood glucose level drops below 3.3 mmol / L), a glucose solution is administered.
In order to correct electrolyte disturbances, solutions containing potassium salts are introduced.
Adjust the pH level.
Antibiotics are used to prevent infectious complications.
To prevent thrombosis (blood clots in the vessels), anticoagulants are prescribed.
Additional measures
In addition, with a disease such as ketoacidosis (what it is, was described above), you should refuse to take carbohydrate-containing foods, with the exception of easily digestible carbohydrates. It is recommended to give preference to sweet glucose-containing products - grape juice, honey. This is especially true in cases when, under the influence of intense insulinoterpia, the glucose content in the blood decreases very quickly and there is a risk of hypoglycemia.
If the therapy is carried out correctly, then the rate of decrease in blood glucose is 4-4 mmol / l / h. 3 hours after the start of treatment, the content of ketone bodies in the urine may temporarily increase. After about 6 hours, they disappear completely.
The adequacy of the treatment of ketoacidosis is determined by the normal blood glucose, as well as the mandatory absence of ketones in the urine.
There are cases when the disease develops against the background of another ailment, and, changing only the insulin therapy scheme, it is impossible to normalize the patient's well-being, as additional drugs are needed, the action of which is aimed at treating the concomitant disease. For example, if a ketoacidotic condition occurs on the background of pneumonia or tonsillitis, the doctor will prescribe antibiotics without fail.
Diabetic ketoacidosis can provoke such serious consequences as serious disturbances in the functioning of internal organs, the development of a diabetic coma, loss of consciousness, and death if not treated properly (occurs in approximately 5-15% of cases).
If the child has a problem
The danger of developing a pathological condition is especially great in childhood. At risk are:
babies who are often sick;
children whose parents have any autoimmune diseases;
artificial babies from birth;
children whose families already have a child who is diagnosed with type 1 diabetes;
newborns whose mothers suffered severe infectious diseases during pregnancy.
Ketoacidosis in children most often develops if type 1 diabetes was not detected on time. In the future, the frequency of cases of such a phenomenon depends on how correct the treatment will be.
Traditionally, ketoacidosis in children is considered as a symptom of type 1 diabetes mellitus, but in some cases this condition can also develop with a type 2 disease.
Diabetic ketoacidosis in childhood is manifested by the same symptoms as in adults. The treatment is also similar. Parents need to constantly monitor their child, and then they will have the opportunity to take appropriate measures and prevent a diabetic coma.
The dosage of water-salt solution, insulin and other drugs is determined by the doctor and depends on the patient's body weight.
Preventive actions
So, ketoacidosis. What is it and what are the principles of treatment - we found out. But you should also familiarize yourself with the methods of prevention.
If ketone bodies are found in the urine, it is necessary to take measures to remove them from the body as soon as possible.
Monitor the amount of sugar in the blood and urine.
Strictly follow your own schedule of insulin therapy, and if you deviate, you should control not only the glucose content in the blood, but also the presence of ketone bodies in the urine.
With special care, you should take alcoholic beverages (alcohol can reduce the amount of sugar in the blood, and it can turn into ketone bodies - this can provoke a very dangerous combination of ketoacidosis and hypoglycemia) and monitor the appearance of ketone bodies in the urine during and after drinking.
Refuse from excessive physical exertion and control the appearance of ketones in the urine during and after physical activity.
Whenever possible, eliminate stressful situations. After severe stress, it is necessary to control both the amount of glucose in the blood and the ketones in the urine.
In case of infectious diseases (tonsillitis, influenza, acute respiratory infections, infections of the genitourinary system, etc.), stroke, myocardial infarction, surgical interventions, various injuries, stresses, pregnancy, urinalysis for the presence of ketone bodies must be carried out without fail.
Conclusion
After reading this article, you learned more about such a pathological condition as ketoacidosis: what it is, symptoms, causes, treatment and prevention methods. If suddenly the amount of sugar in the blood rises or ketone bodies appear in the urine, you should not panic. In this case, it is necessary to identify the cause of the condition and timely conduct adequate treatment. Only an experienced specialist can do this. Self-medication is dangerous to health. Take care of yourself!