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What Is Involved in the Management of Ketoacidosis?

By Lynelle Harmon
Updated May 17, 2024
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Ketoacidosis is a diabetic side effect where improper insulin levels lead to the body feeding on fat for fuel, creating dangerous ketone acids as a byproduct. Common symptoms include nausea and vomiting, flushed skin, and sweet smelling breath; anyone experiencing these should seek immediate medical attention. The condition is usually diagnosed with both a urine sample and blood test, and it can be caused by improper insulin dosage, infection, or injury. Management of ketoacidosis may involve stabilizing insulin levels, hydration, and finding an underlying cause.

Insulin is a biological hormone that converts blood sugar to energy for the body. Diabetics aren’t able to produce enough insulin naturally, but can correct the problem with medicinal insulin. When insulin levels fall too low, the body converts its fat for energy. The breakdown releases potentially poisonous acids called ketones into the blood and urine, creating the condition ketoacidosis.

Diabetics must be aware of the symptoms of ketoacidosis, as the condition requires fast treatment or it can become critical. Symptoms include flushed skin, vomiting, and breath with a fruity smell. It is common for people to receive an initial diabetes diagnosis from experiencing the onset of ketoacidosis. Those who haven’t yet been diagnosed but present with these symptoms should contact a doctor for diabetes testing.

Patients with diabetes are often automatically tested for the condition when diagnosed with illnesses such as pneumonia or after undergoing surgery. Those scenarios weaken a diabetic body, leaving it more prone to insulin malfunctions. Management of ketoacidosis is best done when caught early as the treatment methods will be simplest.

Once diagnosed with a urine sample and a blood test to measure insulin levels, management of ketoacidosis begins with a doctor-prescribed insulin dosage that will rectify the imbalance. This is typically done in a hospital setting so that the levels of ketones and glucose can be closely measured over time. When blood sugar levels reach below 240 mg/dL or 13.3 mmol/L, the patient might be allowed to resume self-injecting insulin.

Hydration is also important in the management of ketoacidosis since vomiting is a common symptom. Ketosis-related dehydration can cause organ damage if left untreated. Fluids with electrolytes will be prescribed and may be administered intravenously in cases of severe dehydration.

The cause of the ketoacidosis onset may be unknown. This requires further testing to discover and treat the underlying condition, which may involve a wide range of blood tests and possible body scans to search for problems. Management of ketoacidosis isn’t effective if the underlying cause isn’t caught.

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