Diabetic ketoacidosis, a common metabolic emergency
DOI:
https://doi.org/10.18041/2665-427X/ijeph.2.9955Keywords:
Diabetic Ketoacidosis, Ketosis, Type 2 diabetes mellitus, Hyperglycemia, metabolic emergencyAbstract
Introduction: Diabetic ketoacidosis (DKA) is a serious metabolic complication and emergency of diabetes with significant morbidity and mortality. It occurs in both type 1 and type 2 diabetic patients. Its incidence is low, but late recognition and treatment can cause multiple complications.
Objective: To review the key concepts of CAD from its definition, epidemiology, etiology, pathophysiology, clinical presentation, diagnostic criteria, and treatment in clinical practice.
Methods: a synopsis and review of the literature was carried out according to the paper presented at the Congress of the Colombian Association of Internal Medicine (ACMI) - Valle Chapter, Universidad Libre: "A multidisciplinary approach with a Latin American vision" on the 13th and 14th May 2022.
Results: DKA is characterized by uncontrolled hyperglycemia, metabolic acidosis, and increased body ketones, causing diverse symptoms. There are multiple triggers, but the main ones are lack of adherence to drug therapy, infectious processes, and the onset of diabetes. It is characterized by an absolute or relative insulin deficiency, which generates an elevation of counterregulatory hormones, generating an increase in gluconeogenesis, low peripheral sensitivity to insulin, perpetuating hyperglycemia. Additionally, lipolysis is increased by generating the oxidation of free fatty acids into ketone bodies. Treatment is based on restoring circulating volume, suppressing ketogenesis and promoting ketone clearance, correcting hyperglycemia and electrolyte abnormalities.
Conclusion: Identifying and adequately treating DKA saves lives, the main thing being the timely restoration of homeostasis. Management must be interdisciplinary to avoid recurrence, promoting diabetes education.
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