Diabetic ketoacidosis

Alternative names:

diabetic coma; DKA; ketoacidosis

Definition:

A complication of diabetes mellitus that results from by-products of fat metabolism (ketones) when glucose is not available for a fuel source in the body.

Causes, incidence, and risk factors:

In a person with diabetes, if insulin is not present for the body to use glucose as a fuel source, body fat is used as fuel. The by-products of fat metabolism are ketones. Ketones build up in the blood and "spill" over into the urine. A condition called ketoacidosis develops when the blood is more acidic than body tissues. Blood-glucose levels become elevated above 300 mg/dL because of increased production of glucose in the liver and decreased glucose uptake by the cells. Diabetic ketoacidosis may be the first symptom of a person with Type I diabetes; or it may be the result of increased insulin needs in Type I diabetes because of infection, trauma, heart attack, or surgery. People with Type II diabetes usually develop ketoacidosis only under conditions of severe stress. Poor compliance with diet and treatment is usually the cause when episodes are recurrent.