What Causes Diabetic Ketoacidosis (DKA)

300Diabetic ketoacidosis.  Diabetics everywhere know this term, . . . I hope.  What is diabetic ketoacidosis?  How is it different than ketosis?

I’ll start by explaining ketosis, and try to keep the sciencey (Yes it’s a word.  It’s MY word.) stuff to a minimum.  Ketosis is a natural body process that occurs when your muscles require fuel, but there’s none in your system.  That fuel starts out as carbs.  If you don’t get enough carbs, your body will naturally enter ketosis when your body starts to break down your fat, thus producing ketone bodies which it can use as fuel.  Your brain and your heart actually run more efficiently on ketones, than they do on glucose.  Our bodies were built to do this, to survive when there was no game to hunt, no plants to forage, no food nearby.  This is NOT dangerous, . . . it’s natural, unless you’re diabetic.  Why is it only dangerous for diabetics?

Because ketone bodies are acidic, and when they reach a certain level, a non-diabetic will secrete insulin, which reduces the ketones just like it does blood glucose.  We of course don’t have this mechanism.  When a diabetic gets ketones, and their blood glucose is above 250, this is the formula for diabetic ketoacidosis.  I know what you’re thinking.  I still haven’t told you what causes it.  Well, here we go.

What causes it is simply a lack of insulin or fuel.  A lack of insulin caused by a faulty infusion set, simply not taking your insulin, being sick and dehydrated, or not eating enough carbs.  The reason your body would enter ketosis is that it doesn’t have enough fuel in the form of carbs, OR . . . it has plenty of fuel, but not enough insulin to get it into the muscle cells.  If the body cannot process or does not have fuel, it will create it by breaking down fat.  This is ketosis.  NOW, your body can’t use the carbs you’ve eaten due to lack of insulin, AND ketones are rising because of lack of insulin.  Rising ketones turn your blood acidic.  This is what can kill you.  If you’re sick and you’re vomiting or have diarrhea, it’s even worse because that creates dehydration which causes insulin resistance!  Ever had ketones while you’re sick, and wonder why in the heck you have to take 3 times the insulin to bring down your blood sugar and ketones?  You need insulin for the blood sugar, for the ketones, and to compensate for the insulin resistance.  Now I can see the wheels turning in your head.

When you go to the hospital, they’re going to treat you with a saline IV, an insulin drip, and electrolytes.  These treat all of the symptoms of DKA all at once, and bring you back to normal.  Your dehydration, your high blood sugar, your high ketones, and your low electrolytes.  So . . . clear as mud now?  Well, I hope it’s clearer than mud for you.

 

********** Now ya know, and knowing is half the battle.  Go Joe!!! **********

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Dehydration and Diabetes

Do you know that dehydration and diabetes go hand in hand?  Did you know that if you have diabetes and a high blood sugar, it can cause dehydration, which causes a high blood sugar AND temporary insulin resistance, causing an even higher blood sugar?  Yeah, neither did I for the longest time.  When I was a kid, my mom used to tell me that dark urine meant my sugar was high.  That’s true.  The urine is dark because my kidneys are trying to reduce my blood sugar by filtering it out in the urine, which can lead to dehydration.

When you have a high blood sugar, the body tries to correct this naturally, by removing the  glucose from the blood stream, filtering it through the kidneys, and out of the body when you urinate.  This is what causes your urine to become dark.  If you become dehydrated as a result of this, your network of blood vessels can’t deliver nutrients or INSULIN as well, so your insulin won’t work the way it should (temporary insulin resistance).  Now you bolus, but your blood sugar won’t go down.  Sound familiar?

Have you ever noticed that when your blood sugar is high, you have to pee a lot?  When you’re peeing, you’re helping, and making it worse at the same time.  You’re getting the glucose out of your system, and you’re making the insulin resistance worse.  It’s a catch 22, right?  Wait, it gets worse!

The next thing the frequent urination causes, is an electrolyte imbalance.  Some common symptoms of the imbalance are muscle cramps, trembling, mental confusion, and many more.   Do these symptoms sound familiar?  Common electrolytes are sodium, potassium, magnesium, calcium, and chloride.  I use Real Salt and Himalayan Salt in my house, and eat avocados almost every day to keep my electrolyte levels up all the time.  Electrolytes are needed for most of your bodies functions, including the beating of the heart and other muscle action.  Without them, we die.  (Check out my guest blog about the diabetic superfood, the avocado on Diabetes Daily.)

So now we have a recipe that causes that dreaded 3 letter abbreviation we all know.  DKA (Diabetic Ketoacidosis)  DKA happens because the body can’t utilize the insulin you’re injecting, so it turns to burning fatty acids which don’t require insulin.  The body starts to break down fat cells into fatty acids, which releases ketone bodies, both of which can be used for fuel.  Insulin is what brings down the level of ketone bodies in your blood, just like glucose.  Since insulin isn’t working at this point, your ketones rise to dangerous levels, making your blood pH acidic, and you can end up in the emergency room.

When you go to the hospital, they treat you with an IV of saline (salt water), insulin, and electrolytes.  This is the combination to correct dehydration, and thus DKA.  To prevent dehydration, and DKA, my advice is to always drink lots of water, eat avocados, and use a good quality sea or himalayan salt.  When your blood sugar is a little high, put a pinch of salt in a bottle or glass of water and drink up.  Problem averted.

Symptoms of dehydration include frequent urination, dry mouth, weakness, lightheadedness, muscle cramps, sweating stops, and more.  Easy ways to check for dehydration are the color of the urine, and the skin test in the picture to the right ———->

Oh, by the way, caffeine makes dehydration worse because it makes you pee.  So don’t think your soda, coffee, or tea will help in preventing dehydration.    Drink water, . . . just plain water, in a dehydration scenario.

********** Now ya know, and knowing is half the battle.  Go Joe!!! **********

If you found this article helpful, please give it a LIKE and share it with others who might benefit from it.  Thanks for paying it forward!  If you’d like to connect with me, you’ll find my social networking profiles to the right:  ————————>

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