Diabetic Ketoacidosis

Diabetics are prone to a condition known as DKA or Diabetic Ketoacidosis. This condition occurs primarily to Type I diabetics but can occur in the Type II diabetics and newly diagnosed diabetics. This is one of the most severe forms of dehydration for any diabetic. Furthermore it has many consequences such as renal failure, pulmonary edema, cardiac events (myocardial infarction or heart attack), and gastrointestinal disorders. We want to look at a few of the major signs and symptoms, something healthcare providers term Poly, Poly, and Poly. This stands for Polyuria, Polyphagia, and Polydipsia.

When blood sugar concentrations are too high and there is not an adequate level of insulin, or no circulating insulin, the body cannot use carbohydrates for energy. They must switch hats and use other things like muscle and fat for a source of energy. The problem here is that these sources are not as effective as carbohydrates and create a byproduct that can be very damaging to the body.

As sugar levels get to high it causes the body to take fluid (water) from inside the cell and in between the cells in tissues. As you remove water from these areas (extra cellular and intracellular) the cells become dehydrated and cannot perform their normal chemical processes; hence you become dehydrated. This is an attempt to balance out the high levels of glucose in the blood and further assist in buffering the acidic state of the blood stream. Further dehydration occurs as your body begins to expel more urine to clear the body of these byproducts (ketones) and excess glucose; free water loss. Actually you can lose up to 6 Liters of free water in the early stages. Remember that the body must have water to function, for Pete's sake we are 60% water anyhow.

Polyphagia occurs because the body is requiring energy and cannot use the carbohydrates that you are eating. As you eat the body is not using the contents of the food and you continue to lose water weight (acute weight loss is a symptom). This means that no matter how much you eat your body cannot use the resources, it is breaking down fat and muscle to get energy.

Polyuria comes from the elimination of increased ketones in the body (ketonuria) and you have exceeded the kidney's threshold for absorbing glucose. The continuation or making urine aids in the free water loss that we spoke of earlier. Dehydration will occur more rapidly. Because the body is excreting the ketones and glucose, you lose further electrolytes like sodium and potassium because of something called osmotic diuresis. Osmotic diuresis is when the concentration gradient in the blood and organs has changed dramatically. In this scenario water is being pulled from the intra and extra cellular areas to balance the bloodstream; remember water moves from an area of low concentration to an area of high concentration during osmosis.

Polydipsia occurs as a result from the thirst sensors in the body and a signal from the hypothalamus. The hypothalamus signals you to drink more water because the cells of the body are drying up. This is an attempt by the body to correct the dehydration process. The problem is that you are severely dehydrated, your gastric motility may be slowed, and you have continued vomiting. You require more than what you can physically drink to counteract the problems with homeostasis and blood sugar stabilization.

About the Author

Michael Leff is a healthcare practitioner of 15 years with a focus in emergency, trauma, and critical care. He promotes concepts of health and wellness through his blog at http://www.nurseconnector.com