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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