On May 4, 2008, my dad (age 55) died of a silent heart attack and diabetic ketoacidosis (DKA). The sad part about this is that I did not know anything about DKA. Neither did my mother or my sister. We had no idea about this condition because it is not made widely available to the public and is hidden from those who want information.
Information about diabetic ketoacidosis can be found if “diabetic ketoacidosis” or “DKA” is searched. However, no information is found about it if “diabetes complications” or “diabetic complications” is searched. In fact, even the American Diabetes Association does not publish information on this fatal diabetic complication.
I e-mailed the American Diabetes Association about making more information about DKA public and widely available. I was ignored and given the following form letter.
Dear Bridget,
Thank you for contacting your American Diabetes Association. We have received your e-mail regarding diabetes education.
In order to better serve you, your e-mail is being forwarded to the proper department. We appreciate your input. You may also visit our website link provided below for public service announcements.
The ADA link included in the e-mail
To receive our free packet of information on diabetes management and wellness, please reply to this e-mail with your full name and mailing address.
In addition, the American Diabetes Association offers memberships to both Consumers and Health Professionals. A general membership application form is included in the information packet that we send out. We also have free electronic newsletters. So if you’re looking for diabetes news updates, book information or ways to get involved, the American Diabetes Association has an e-newsletter that’s right for you. Please visit our website links provided below for more information.
Membership
Electronic Newsletter
You may also contact our National Call Center at 1-800-342-2383 or visit us on the web at www.diabetes.org.
Sincerely,
Jane Nyondo
Coordinator, National Call Center
American Diabetes Association
www.diabetes.org
Of course, what this really means is that they have just trashed my e-mail to them and do not care about what I have to say.
So, what is diabetic ketoacidosis and what are the warning signs of DKA?
Diabetic Ketoacidosis is a state of inadequate insulin levels resulting in high blood sugar levels. This causes an accumulation of organic acids and ketones in the blood. While DKA is more common in Type 1 diabetics, it works exactly the same way in Type 2 diabetics. A diabetic cannot realize when DKA sets in because the diabetic will often simply feel sick and then become confused and irrational, not able to recognize any of the warning signs.
It is very important that those around the diabetic are able to recognize the warning signs. That way there may be a chance of saving the diabetics life, though DKA takes places in less than 24 hours. In fact, it may occur simply within an afternoon or an evening.
In DKA, the blood sugar becomes too high and this makes the blood too acidic (a pH of 7 or lower is considered incompatible with life). This happens because when the insulin levels are insufficient, the body enters a starving state and the brain starts using ketone bodies as a fuel source instead of glucose.
Obviously, it is important for a diabetic to always check his or her blood sugar levels. Whenever the blood sugar level is over 300, a diabetic needs to be brought to a doctor, hospital, or urgent care clinic. The only time that this should not happen is if the diabetic has other specific instructions from a physician. By carefully monitoring blood sugar levels, DKA may be avoided.
Even early warning signs of diabetic ketoacidosis can be difficult for those who are around a diabetic to detect as they seem like normal symptoms of common illnesses. Some symptoms that may appear in the early stages of DKA are the following.
Sluggishness
Extreme Tiredness
Extreme thirst, despite large fluid intake
Constant urination
Fruity smell to breath (like nail polish or peardrops)
Hyperventilation (at first shallow and rapid and then to a deeper and less rapid difficulty breathing)
Extreme weight loss
Oral Thrush
Yeast infections
Muscle wasting
Agitation
Irritation
Aggression
Confusion
Of course, not all of these symptoms may be present. Thus, it is extremely difficult for DKA to be detected in early stages.
The late warning signs of diabetic ketoacidosis follow. Once DKA has entered into the late stages, medical treatment must be sought immediately or the diabetic will surely die.
Vomiting
Confusion
Abdominal Pain
Loss of Appetite
Flu-like Symptoms
Lethargy
Apathy
Extreme Weakness
Kussmaul Breathing (somewhat like hyperventilation, but not as rapid and shallow)
If a diabetic ever says, “I’ll take care of my diabetes later,” make sure to get that person immediate medical attention.
Unfortunately, even when DKA is treated, sometimes there is nothing that can be done to help the person. The diabetic, if treated successfully, will definitely end up spending time in the ICU.
It is also important to keep an eye out for those who have any risk of diabetes as it is often first diagnosed because diabetic ketoacidosis takes place and a person is brought to the hospital for treatment and is treated for DKA and then is diagnosed with diabetes.
Also note that DKA is often the last thing to take place when an diabetic is having a heart attack. Often, diabetes will hide all symptoms of a heart attack – and that includes any pain or numbness, so a diabetic will often have a silent heart attack and never know he or she is having one until it is too late (as was the case with my dad as well).
