Acute complication of uncontrolled diabetes mellitus endangers the patient’s life and is characterized by urinary loss of water, potassium, ammonium and sodium in hypovolemia, electrolyte imbalance, very important elevation of blood glucose levels and degradation free fatty acids. This determines a state of acidosis which is often accompanied by coma.
It occurs with a frequency of 4-8 cases per 1000 diabetics per year, from 20% to 30% of cases occur in those who present with the disease. It occurs more frequently in type I diabetics and adults, typically between the youngest (28-38 years), with no predilection for any sex.
CLINICAL
Although the symptoms of poorly controlled diabetes mellitus may be present from several days earlier, the metabolic alterations typical of CAD usually develop quickly (usually within 24 hours).
The clinical picture includes a history of polyuria, polydipsia, weight loss, nausea, vomiting and decreased appetite. This anorexia relative importance as the first manifestation of the transition from simple hyperglycemia ketosis. Occasionally appears in the adult abdominal pain (more common in children)
COMPLICATIONS
The most common complications of DKA include: 1) hypoglycemia due to excessive treatment with insulin, 2) hypokalemia: caused by insulin administration and treatment of acidosis with bicarbonate and 3) hyperglycemia: secondary to insufficient insulin treatment (The first two have been significantly reduced with the use of low doses of insulin).
Cerebral edema is a rare but almost always fatal. The asymptomatic is not uncommon among children and young adults is extremely rare, while the development of symptoms in adults. Disease characterized by impairment of consciousness and headache, seizures can occur, changes in the lungs, respiratory arrest and bradycardia (symptoms and signs progress as if there was a herniation). Some patients have warning signs (headache of sudden onset or rapid decrease in level of consciousness), but in others the initial manifestation is respiratory arrest. Mortality is high (> 70%). Hyperventilation have been used, steroids and mannitol, but tend to be ineffective after respiratory arrest.
TREATMENT
The treatment is urgent and immediate, and has two main objectives:
1) correction of dehydration and
2) correction of hyperglycemia.
The information I have placed here is to create a little awareness about the seriousness of diabetes and the importance of regular checkups because this complication usually occurs in uncontrolled diabetes (patients not taking their medications and do not meet your diet or people who did not know they had diabetes)
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