Ketoacidosis - what is it? Ketoacidosis: symptoms, signs and treatment of the disease in adults and children

Today we will consider such a common complication of diabetes mellitus, as ketoacidosis. What it is? What are the causes and principles of treatment? How to prevent the development of the disease? We will discuss these questions in the article.

General information

The main cause of the development of this pathology is insulin deficiency, as a result of this, blood glucose levels rise and urine is intensively formed. That leads to dehydration of the body, loss of salts, splitting of fats. During the decomposition of fat, ketones are produced - special substances that can increase the acidity of the blood. Ketoacidosis is a disease that has an acute course and develops very rapidly. In some cases, this pathology is the first sign of type 1 diabetes .

Causes

The disease can develop as a result of:

• An incorrect calculation of the dose of insulin or missed injection.

• Infectious intoxication.

• Serious violations in the usual diet.

• Late diagnosis.

• Changes in the need for insulin, which can be caused by the production of growth hormone, surgical intervention, changes in the habitual rhythm of life, stress.

• Insufficient self-control in eating.

Ketoacidosis: symptoms of the disease

Ketone bodies, produced in excess, negatively affect the body, and over time, signs of poisoning appear. If ketoacidosis develops, the symptoms of pathology are expressed as:

• Nausea;

• Vomit;

• Frequent abdominal pains, sometimes very severe;

• Weight loss;

• The appearance of deep, noisy, frequent breathing;

• Headache, dizziness;

• Drowsiness, lethargy.

Also, with such an ailment there are weak cramps of limbs, the smell of acetone from the mouth, the skin becomes excessively dry, there is a complete or partial loss of orientation in space.

An objective indicator of ketoacidosis is the presence of acetone in the urine, which can easily be determined with the help of special test strips.

Detection of one or more symptoms requires specialist advice.

Diagnostics

To diagnose ketoacidosis, it is necessary to carry out certain studies. These include:

1. General inspection.

2. An analysis of the patient's medical history and complaints.

3. Laboratory studies, including:

• Analysis of the amount of glucose in the blood;

• General analysis of blood and urine;

• Determination of the presence of ketone bodies in the blood:

• Urine analysis for acetone and ketone bodies;

• Determination of the presence of ions in the blood (potassium, sodium), the level of creatinine, urea, chlorides, lactate, bicarbonate;

• Analysis of acid-base ratio of blood and gas composition.

Ketoacidosis: treatment of pathology

This ailment requires immediate medical intervention. With a disease such as ketoacidosis, treatment is primarily to restore the potassium and water balance in the body of the patient. It is also very important to reduce the amount of sugar (to normal values) and the acidity of the blood.

Treatment of ketoacidosis in diabetes mellitus includes such activities:

1. Intravenously inject insulin with short action (a hormone that helps to reduce the amount of glucose in the blood) and hourly control the blood glucose.

2. Solutions of sodium chloride (in various concentrations) make up for the deficiency of liquid.

3. To prevent hypoglycemia (a condition in which the blood glucose level falls below 3.3 mmol / l), a glucose solution is introduced.

4. To correct the electrolyte disturbances, solutions containing potassium salts are introduced.

5. Correct the pH level.

6. Antibiotics are used to prevent infectious complications.

7. To prevent thrombosis (blood clots in blood vessels), anticoagulants are prescribed.

Additional measures

In addition, with a disease such as ketoacidosis (which is what was described above), you should stop taking hydrocarbon-containing foods, except digestible carbohydrates. It is recommended to give preference to sweet glucose-containing products - grape juice, honey. Especially it concerns those cases when under the influence of intensive insulinotherapy the glucose content in blood decreases very quickly and there is a risk of development of hypoglycemia.

If the therapy is carried out correctly, then the rate of reduction in blood glucose is 4-4 mmol / l / h. After 3 hours after the treatment was started, the content of ketone bodies in the urine may temporarily increase. After about 6 hours they disappear completely.

The adequacy of the treatment of ketoacidosis is determined by the normal content of glucose in the blood, as well as the mandatory absence of ketones in the urine.

There are cases when the disease develops against the background of another ailment, and, having changed only the scheme of insulin therapy, it is impossible to achieve normalization of the patient's well-being, since additional medicines are needed, the action of which is directed to the treatment of the concomitant disease. For example, if a ketoacidotic condition occurs against the background of pneumonia or tonsillitis, the doctor will prescribe antibiotics.

Diabetic ketoacidosis can provoke such serious consequences as serious violations in the work of internal organs, the development of diabetic coma, loss of consciousness, and in the absence of appropriate treatment - a fatal outcome (occurs in about 5-15% of cases).

If the child has a problem

The danger of developing a pathological condition is especially great in childhood. At risk are:

• Kids who often get sick;

• Children whose parents have any autoimmune diseases;

• Artificial babies from birth;

• Children whose families already have a child diagnosed with type 1 diabetes mellitus;

• Newborns whose mothers suffered severe infectious ailments during pregnancy.

Ketoacidosis in children most often develops if the type 1 diabetes has not been detected in time. In the future, the frequency of cases of this phenomenon depends on how correct treatment will be.

Traditionally, ketoacidosis in children is considered as a symptom of type 1 diabetes, but in some cases this condition can develop with type 2 disease.

Diabetic ketoacidosis in childhood is manifested by the same symptoms as in adults. Treatment is also similar. Parents need to constantly monitor their child, and then they will have the opportunity to take appropriate measures and prevent the diabetic coma.

The dosage of water-salt solution, insulin and other drugs is determined by the doctor and depends on the patient's body weight.

Preventive actions

So, ketoacidosis. What is it and what are the principles of treatment - we found out. But you should also get acquainted with the methods of prevention.

1. If ketone bodies are found in the urine, it is necessary to take measures to remove them from the body as soon as possible.

2. Control the amount of sugar in the blood and urine.

3. Strictly adhere to your own schedule of insulin therapy, and in case of deviation, you should control not only the glucose content in the blood, but also the presence of ketones in the urine.

4. With extreme caution should be taken alcoholic beverages (alcohol can reduce the amount of sugar in the blood, and itself turn into ketone bodies - this can provoke a very dangerous combination of ketoacidosis and hypoglycemia) and monitor the appearance of urine in the urine of ketones during and after drinking.

5. Abandon excessive physical activity and keep under control the appearance of ketones in the urine during and after physical activity.

6. If possible, eliminate stressful situations. After suffering severe stress, it is necessary to control both the amount of glucose in the blood and ketones in the urine.

7. In case of infectious diseases (angina, influenza, acute respiratory infections, genitourinary infections, etc.), stroke, myocardial infarction, surgical interventions, various traumas, stress, pregnancy, urine should be examined for the presence of ketone bodies.

Conclusion

After reading this article, you learned more about such a pathological condition as ketoacidosis: what is it, symptoms, causes, methods of treatment and prevention. If the amount of sugar in the blood suddenly increases or if ketone bodies appear in the urine, you should not panic. In this case, it is necessary to identify the cause of the condition and promptly conduct adequate treatment. Only an experienced specialist can do this. Self-treatment is dangerous to health. Take care of yourself!