What is ketoacidosis?
The ketoacidosis is a form of metabolic acidosis, the most frequently occurs as a complication of diabetes mellitus in absolute insulin deficiency. The reason is a too high concentration of ketone bodies in the blood.
Ketoacidosis causes
With the development of ketoacidosis, the organic acids acetoacetic acid and hydroxybutyrate (ketone bodies) in the blood accumulate and reduce its pH, caused by a long-lasting absolute insulin deficiency. Mild forms of ketoacidosis caused by prolonged fasting (starvation, fasting) through the increased fat and protein breakdown for energy.
The insulin deficiency in turn leads to increased fat in the liver is reduced, thereby increasing acetyl-CoA is formed from acetoacetate in turn, creates the salt of acetoacetic acid. Acetoacetate is the "Starvation response" under physiological conditions for a further metabolic step as an energy source in tissue.
The most common is the catabolic situation in insulin deficiency in the context of a derailed diabetes mellitus cause (diabetic ketoacidosis) for the accumulation of organic acids in the blood. As another typical cause is considered the massive increase in hydroxybutyric acid in the blood due to alcohol consumption (alcoholic ketoacidosis). Alcohol inhibits gluconeogenesis and the free fatty acid oxidation in the liver. Even as a hereditary congenital deficiency of succinyl-CoA acetoacetates transferase (SCOT syndrome) can trigger them.
Clinical appearance
The ketoacidosis presents clinically by nonspecific symptoms such as vomiting, polyuria, thirst and weakness. In the further course of the disease in haze of consciousness up to the loss, the Kussmaul breathing with acetone odor of breath and dehydration (dehydration). The disease, if not treated fatal.
Diabetic ketoacidosis treatment
Therapeutically are the completion of the causal, catabolic action by the administration of insulin and adequate fluid intake because of the accompanying dehydration in the foreground. In addition to general emergency or intensive care measures to maintain the vital functions is to recognize other potentially life-threatening changes early enough, can a consistent biological monitoring of those affected necessary. In particular, significant deviations of blood glucose and potassium levels in the blood need in the early stages often prompt intervention.