Thumbnail image of: Diabetes, Injection Rotation Chart: Illustration
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Thumbnail image of: Subcutaneous Shot, How to Give: Illustration

Diabetic Ketoacidosis

What is diabetic ketoacidosis?

Having diabetes means that there is too much sugar (glucose) in your blood. When you eat food, your body breaks down much of the food into glucose. Your blood carries the glucose to the cells of your body. An organ in your upper belly, called the pancreas, makes and releases a hormone called insulin when it detects glucose. Your body uses insulin to help move the glucose from the bloodstream into the cells for energy. When your body does not make insulin (type 1 diabetes), or has trouble using insulin (type 2 diabetes), glucose cannot get into your cells. The glucose level in your blood goes up. Too much glucose in your blood (also called hyperglycemia or high blood sugar) can cause many problems.

People with type 1 diabetes are at risk for a problem called diabetic ketoacidosis (DKA). It is very rare in people with type 2 diabetes. DKA happens when your body does not have enough insulin to move glucose into your cells, and your body begins to burn fat for energy. The burning of fats causes a build-up of dangerous levels of ketones in the blood. At the same time, sugar also builds up in the blood. DKA is an emergency that must be treated right away. If it is not treated right away, it can cause coma or death.

What can I expect in the hospital?

You will need to stay in the hospital in order to bring your blood sugar level under control and treat the cause of the DKA. Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include:

Monitoring

  • You will be checked often by the hospital staff.
  • You may have fingersticks to check your blood sugar regularly. This may be done as often as every hour. You will learn how to check your blood sugar level in order to manage your diabetes when you go home.
  • A heart (cardiac) monitor may be used to keep track of your heartbeat.
  • Your blood oxygen level may be monitored by a sensor that is attached to your finger or earlobe.
  • Your fluid intake may be monitored closely by keeping track of everything you eat and drink and any IV fluids you receive.
  • You may have a small tube (catheter) placed into your bladder through the urethra (the opening from the bladder to the outside of the body) to drain and measure urine from the bladder.

Testing

Testing may include:

  • Blood tests (Hemoglobin A1c) to check your average blood sugar over the past 3 months
  • Blood or urine tests to check for infections
  • Blood tests to test for mineral (sodium and potassium) levels
  • Blood tests to check if your body is making insulin
  • Blood, urine, or other tests to monitor how well your organs are functioning
  • Arterial blood gas (ABG): A blood test to measure the levels of oxygen and carbon dioxide in your blood
  • X-rays: Pictures of the inside of the chest to check for infection

Treatment

The treatment for DKA depends on the cause and how well you respond to treatment. The goal of treatment is to return your blood sugar to a normal level and keep it in a normal range.

  • You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow medicine to be given directly into your blood and to give you fluids, if needed.
  • Your provider may prescribe medicines to:
    • Keep your blood sugar controlled
    • Treat other medical problems that may have been caused by or made worse because of diabetes
    • Treat pain
    • Treat or prevent an infection
    • Prevent blood clots
    • Prevent side effects, such as nausea or constipation, from other treatments
    • Replace vitamins and minerals
  • You may receive oxygen through a small tube placed under your nose or through a mask placed over your face.
  • You may need to stop taking medicines that you were taking that may have caused the DKA.

What can I do to help?

  • You will need to tell your healthcare team if you have new or worsening:
    • Increased urination or trouble emptying the bladder
    • Increased thirst and dry mouth
    • Shortness of breath
    • Nausea or vomiting
    • Abdominal pain
    • Confusion
    • Weakness
    • Tiredness
    • Fruity odor to breath
  • Ask questions about any medicine or treatment or information that you do not understand.

How long will I be in the hospital?

How long you stay in the hospital depends on your symptoms and how well you respond to treatment. The average amount of time to stay in the hospital after DKA is 4 to 5 days.

Developed by RelayHealth.
Acute Care Advisor 2015.1 published by RelayHealth.
Last modified: 2014-04-30
Last reviewed: 2014-04-24
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.

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