Which diagnostic test result supports the diagnosis of diabetic ketoacidosis DKA )?
Diabetic ketoacidosis occurs when a person with diabetes type 1 or 2 has dangerously high levels of ketones in the body. It can be a medical emergency. Show Diabetic ketoacidosis (DKA) is a serious complication of type 1 diabetes and, much less commonly, of type 2 diabetes. DKA happens when your blood sugar is very high and acidic substances called ketones build up to dangerous levels in your body. Ketoacidosis shouldn’t be confused with ketosis, which is harmless. Ketosis can occur as a result of an extremely low carbohydrate diet, known as a ketogenic diet, or from fasting. DKA only happens when you don’t have enough insulin in your body to process blood sugar into energy. If this happens, your liver starts to process fat into energy, which releases ketones into the blood. High levels of ketones in the blood are dangerous. It’s less common in people with type 2 diabetes because insulin levels don’t usually drop so low, but it can happen. DKA may be the first sign of type 1 diabetes, as people with this disease can’t make their own insulin. Symptoms of DKA can appear quickly. Early symptoms of DKA can include:
As DKA progresses, more symptoms may appear:
DKA is a medical emergency. Call your local emergency services immediately if you think you may be experiencing DKA. If left untreated, DKA can lead to a coma or death. If you use insulin, make sure you discuss the risk of DKA with your healthcare team and have a plan in place. If you have type 1 diabetes and have a blood sugar reading of over 240 milligrams per deciliter (mg/dL), you should test yourself for ketones using a urine or blood test. You should also test if you are sick or planning on exercising and your blood sugar is 240 mg/dL or higher. Call your doctor if moderate or high levels of ketones are present. Always seek medical help if you suspect you are progressing to DKA. People with type 2 diabetes are usually at lower risk of DKA. But the risk can increase when your body is under strain due to injury, infection, or surgery. The treatment for DKA usually involves a combination of approaches to normalize blood sugar and insulin levels. If you receive a diagnosis of DKA but haven’t yet received a diagnosis of diabetes, your doctor will create a diabetes treatment plan to keep ketoacidosis from recurring. Infection can increase the risk of DKA. If your DKA is a result of an infection or illness, your doctor will treat that as well, usually with antibiotics. Fluid replacementAt the hospital, your physician will likely give you intravenous (IV) fluids to help your body rehydrate. During a DKA event, you usually lose a lot of fluids, which can reduce the amount of blood flowing through your body. Fluid replacement helps restore typical blood flow. It also helps treat dehydration, which can cause even higher blood sugar levels. Electrolyte replacementWhen your insulin levels are too low, your body’s electrolytes can also become atypically low. Electrolytes are electrically charged minerals that help your body, including the heart and nerves, function properly. Electrolyte replacement is also commonly done through an IV. Insulin therapyInsulin will likely be administered to you through an IV until your blood sugar level falls below 200 to 250 mg/dL. The emergency care team will also monitor several other blood test results that indicate when insulin therapy is no longer needed. When your blood sugar and other test readings are within an acceptable range, your doctor will work with you to help you avoid DKA in the future. DKA occurs when insulin levels are low. Our bodies need insulin to use the available glucose in the blood. In DKA, glucose can’t get into the cells, so it builds up, resulting in high blood sugar levels. In response, the body starts breaking down fat into a useable fuel that doesn’t require insulin. Turning fat into energy produces ketones. When too many ketones build up, your blood becomes acidic. This is diabetic ketoacidosis. The most common causes of DKA are:
Risk factors for DKA include:
MedicationsCertain medications can increase the risk of DKA. These include:
Ketosis-prone diabetesAlthough DKA is less common in people who have type 2 diabetes, it does occur. Some people with type 2 diabetes are considered “ketosis-prone” and are at a higher risk of DKA. A diagnosis of ketosis-prone diabetes is more likely for:
It’s best to talk with your doctor about your risk factors to make sure you have the right treatment plan in place. Testing for ketones is one of the first steps for diagnosing DKA. If you have type 1 diabetes, you should have a supply of home ketone tests. These test either your urine or your blood for the presence of ketones. You can buy these in drug stores or online. When to testAccording to the American Diabetes Association, you should test for ketones:
Test your urine or blood every 4 to 6 hours. How to testUrine test strips change color to signal the presence of ketones in your urine. You’ll need to pee on the strip or dip the strip into the pee you’ve collected in a container. The indicator on the strip will change color. Compare the test strip to the results chart. Blood ketone testers are also available. These are usually combination devices that can measure both glucose levels and ketone levels. Similar to blood glucose testing, you’ll need to apply a small sample of blood to a test strip. The test strip is inserted into a monitor device to test for the presence of ketones in your blood. A doctor or pharmacist can advise you on when and how to use your home ketone tests. There are many ways to prevent DKA. Prevention means following your diabetes treatment plan carefully and taking some extra care when you’re sick. Follow your treatment planYou can lower your risk of DKA with proper management of your diabetes:
When you’re sickAlthough you can’t completely avoid illness or infection, you can take steps to help you remember to take your insulin and to help prevent and plan for a DKA emergency. A “sick day plan” can reduce the risk of DKA:
Call your doctor if you detect moderate or high ketones in a home test. If you can’t reach your doctor and you suspect you may be progressing to DKA, get emergency help. Early detection is essential. DKA is serious, but it can be prevented. Follow your diabetes treatment plan and be proactive about your health. Tell your doctor if something isn’t working for you or if you’re having trouble. They can adjust your treatment plan or help you come up with solutions for better managing your diabetes. Read this article in Spanish. Which diagnostic test results supports the diagnosis of diabetic ketoacidosis?In the hospital, healthcare providers may use the following tests to diagnose DKA: Blood glucose test. Ketone testing (through a urine or blood test). Arterial blood gas.
What test is useful to detect ketoacidosis?B-HB is a better test for ketosis and ketoacidosis than nitroprusside methods for a number of reasons: Beta-Hydroxybutyrate demonstrates excellent stability, making it the most reliable indicator of clinically relevant ketosis and ketoacidosis.
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