Treatment and Complications of Diabetic Ketoacidosis

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Treatment of diabetic ketoacidosis, once confirmed treatment should be done as a medical emergency. Treatment has to be in an emergency room or in a hospital. Treatment include replacement of fluid and electrolytes and insulin administration intravenously.id-100140492

Treatment modalities include,

  • Intravenous fluid replacement is very important in treatment of diabetic ketoacidosis, because dehydration is common. You will receive fluids until hydration is complete. Later on you may be given oral fluids, but initially most patients need intravenous fluids.
  • Electrolyte replacement is another important aspect of treatment. Most electrolytes can be replaced along with intravenous fluids and usually additional administration of electrolytes may not be required. Fluid and electrolytes can be replaced same time. Electrolyte disturbance (e.g. Sodium, potassium, chloride etc.) Is common along with fluid loss due to low level of insulin. Electrolyte replacement is essential for proper functioning of heart, muscles and nerves.
  • Insulin administration: this is usually done using intravenous insulin. Commonly short acting insulin preparations can be given intravenously (insulin is usually administered subcutaneously). Intravenous insulin administration is required in treatment of diabetic ketoacidosis, because it is a medical emergency. Intravenous insulin therapy has to be given until your blood glucose level comes down to at least below 240 mg/dl. After this level of blood sugar is reached, usual subcutaneous insulin can be started. The dose of insulin need to be adjusted to bring down blood glucose level to normal. Administration of insulin is the only way to reverse effects of diabetic ketoacidosis.

What are the possible complications of diabetic ketoacidosis?

Complications of diabetic ketoacidosis occurs mainly due to treatment of the condition. These include,

  • Low blood glucose: over optimistic treatment of diabetic ketoacidosis may sometime lead to hypoglycemia. To prevent hypoglycemia during treatment of diabetic ketoacidosis, frequent blood glucose level monitoring is essential. This is required to adjust insulin dosage. Insulin should not be administered to quickly in high dose to prevent hypoglycemia, which may be more dangerous than original problem of diabetic ketoacidosis.
  • Low potassium level in blood may occur during treatment of diabetic ketoacidosis. Appropriate fluids has to be administered to prevent low potassium level and regular checking of blood potassium level.
  • Too rapid lowering of blood glucose may lead to accumulation of fluid in brain, cerebral edema. Lower blood sugar level gradually by controlled administration of intravenous insulin.

Treatment of diabetic ketoacidosis should be done cautiously, keeping in mind the complications that may arise during treatment, if not rightly done.

 

Image courtesy of [antpkr] at FreeDigitalPhotos.net

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