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Diabetic Ketoacidosis is a risk in severe insulin deficiencies which can occur in untreated Type 1 diabetes, or other specific types of diabetes where there is no insulin
production. It may develop before diabetes has been diagnosed in with advanced metabolic alterations. Or, it can occur in times of acute stress or illness in people with diabetes treated with insulin.
The process by which ketoacidosis develops is:
1. |
Insulin is not present or is in short supply relative to an excess of counter regulatory hormones driven by significant stress or illness.
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2. |
Glucose levels rise in blood, but cell are unable to access it as fuel. |
3. |
Liver cells break down protein and glycogen, converting both into glucose. More glucose is released into the blood. |
4. |
Fat cells release fats into blood as alternative fuel. |
5. |
Muscle cells utilize fat as their primary fuel source, creating an abundance of its waste product, ketones. |
6. |
Ketone levels rise in the blood. They are acidic and change the acid- base chemical balance of the blood. Lungs try to neutralize acid by
changing respiration rate and gas exchange. (Thus the name ketoacidosis is derived.) Sodium, potassium and phosphorus shifts occur in cells. |
7. |
Kidneys excrete very large amounts of water, trying to rid the body of toxic ketones and excess glucose. Sodium, potassium and phosphorus are
simultaneously excreted in urine, and become depleted. |
Ketoacidosis requires immediate intensive medical care including insulin adminstration, rehydration and electrolyte repletion. Without prompt treatment, it can cause death.
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