Diabetic Ketoacidosis

Definition

Metabolic acidosis from the accumulation of ketones due to severely depressed insulin levels.

Diabetic ketoacidosis (DKA) results from grossly deficient insulin availability, causing a transition from glucose to lipid oxidation and metabolism (see below). In type I DM patients, DKA is commonly precipitated by a lapse in insulin treatment or by an acute infection, trauma, or infarction that makes usual insulin treatment inadequate. Although type II DM patients rarely have DKA, many may have ketone formation and acidosis (usually mild) because of a decrease in food intake and a marked decrease in insulin secretion due to severe and chronic
hyperglycemia (glucose toxicity). These patients usually do not require insulin after the acute metabolic event is corrected.

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