Dr Aidin Rawshani

Ketoacidosis and diabetic coma

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Ketoacidosis and coma

Ketoacidosis is a very serious condition that can lead to coma or even death. The condition must be treated immediately and, as a rule, intensive care is required in hospitals. The cells of the body need energy to perform their tasks. Energy comes primarily from sugar, in the form of glucose. The vast majority of cells in the body depend on insulin to absorb glucose. This means that cells must first receive insulin in order to then take up glucose. When we eat food, the pancreas makes insulin that gets into the blood. The insulin is spread throughout the body so that all cells can take up the glucose contained in the food.

If you lack insulin, or have a severe shortage of insulin, the cells cannot take up glucose. When cells don’t get glucose, they use fat as fuel instead. When the cells burn fat, ketones (ketone bodies) are formed. Thus, ketones are substances that are formed when fat is broken down. Unfortunately, ketones are acidic, which causes the body to become acidic (pH drops).

High concentrations of ketones lead to ketoacidosis

Since ketones are acidic, the body becomes more acidic when the concentration of ketones rises in the blood. The medical term for the fact that the body becomes acidosis is “acidosis”. Ketoacidosis simply means getting acidosis due to high levels of ketones in the blood.

Who suffers from ketoacidosis?

The absolute majority of people suffering from ketoacidosis are those with type 1 diabetes. This is explained by the fact that people with type 1 diabetes lack insulin or they have a severe shortage of insulin. People with type 2 diabetes very rarely suffer from ketoacidosis, although it occurs. It has been reported that people with type 2 diabetes who eat a strict low-carbohydrate diet (ketogenic diet) have suffered ketoacidosis but this is probably very rare.

What are the causes of ketoacidosis?

  • Insulin deficiency
  • People with type 1 diabetes must use insulin syringes to supply the body with insulin. If the syringes run out, or if you forget to use them, or if you use too little insulin, you get a lack of insulin. This can lead to ketoacidosis.
  • If you do not know that you have type 1 diabetes, you have insulin deficiency because the pancreas does not produce enough insulin.
  • In case of illness (regardless of the type of disease, such as an infection with fever), the body’s insulin requirements increase. So you need more insulin than normal. Such situations can lead to ketoacidosis in people who have diagnosed type 1 diabetes, as well as those who do not yet know that they have type 1 diabetes.
  • Lack of food and drink
  • If you don’t eat food, the body starts to break down fat and then the ketone concentration in the body rises.

Ketoacidosis develops gradually. It can take several days or even weeks. Not infrequently can be diagnosed with type 1 diabetes associated with ketoacidosis. It is important to consider that when starting vomiting, the condition is very acute and one must immediately call an ambulance.

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