Diabetic Ketoacidosis

Pathophysiology
Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones.The condition develops when your body can't produce enough insulin. Insulin normally plays a key role in helping sugar (glucose) - a major source of energy for your muscles and other tissues - enter your cells. Without enough insulin, your body begins to break down fat as fuel. This process produces a build-up of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated.

Treatment
Diabetic ketoacidosis is an emergency and requires urgent medical attention, often in and intensive care setting. The goal of treatment is to correct the elevated blood glucose level by giving additional insulin and to replace fluids and electrolytes lost through excessive urination and vomiting. You will require close monitoring including regular finger prick glucose measurements, vital observations, fluid charts, blood tests and ECG monitoring. You may need a catheter into the bladder to measure urine output accurately. Monitoring is essential as there is a very fine balance between the fluid and electrolyte levels in your body.
Statistics
Diabetes is a challenging disease for patients, and a major and underestimated source of medical costs and lost productivity for society 1.0-1.1M diabetes patients (~100,000 more diagnosed patients than reported).EUR 4-5 B total medical costs for diabetes patients, of which EUR 2.5 B costs for diabetes treatment and complications (more than double of reported). On top that EUR 6 B lost productivity. Total costs could rise to EUR 16-19 B in 2020, Diabetes care in The Netherlands has reached a high level of quality, but there is still opportunity for further improvement

Research
A blood sugar reading of 11 mmol/l or more is a sign that you're at risk of diabetic ketoacidosis and should check your ketone level if you feel ill. A ketone level reading of 2+ or more on urine strips or 0.6 mmol/l or more in your blood is a sign that you need to take immediate action to correct your levels.Adjusting your insulin dose as advised by your diabetes care team will often correct your blood sugar and ketone levels, preventing diabetic ketoacidosis. Seeking medical advice if levels remain high after taking insulin.