Diabetic ketoacidosis (DKA) is a life-threatening complication in patients with diabetes mellitus. Near complete deficiency of insulin and elevated levels of certain stress hormones increase the chance of a DKA episode. DKA is more common among Type I diabetics, but may also occur in Type II diabetics, particularly during periods of increased physiologic stress, such as during an infection. Patients with new, undiagnosed Type I diabetes frequently present to hospitals with DKA. DKA can also occur in a known diabetic who fails to take prescribed insulin, or in diabetics who fall sick due to illnesses such as pneumonia or a kidney infection. DKA was a major cause of death in Type I diabetics before insulin injections were available; untreated DKA has a high mortality rate.
DKA is characterized by high blood sugar, acidosis, and high levels of ketone bodies. The pathogenesis of DKA is mainly due to acidosis. Excessive amounts of ketone bodies lower the blood pH; a blood pH below 6.7 is incompatible with life. Onset of DKA is often within 24 hours.
