Understanding and Diagnosing Ketoacidosis: Symptoms & Causes

Ketoacidosis is an acidosis caused by an increase in the production of ketones, frequently as a result of diabetes. Acidosis is defined as a pH of 7.4 or less in the arterial blood. In the case of diabetes, an insulin deficiency increases the levels of fatty acids that produce the ketones acetoacetate and beta-hydroxybutyrate when oxidized by the liver.

Instructions

• 1

  Observe extreme thirst and urination as the first symptoms of ketoacidosis. This can develop over several days as the first presentation of diabetes and can easily be missed in a child still wearing diapers.

• 2

  Expect a much more rapid development of these symptoms in the case of a patient with established diabetes, especially when insulin therapy is omitted. Ketoacidosis can present with a blood sugar level less than 250 mg/dL under these circumstances.

• 3

  Look for additional symptoms of ketoacidosis. Children with a continuous subcutaneous insulin infusion may present with severe abdominal pain and vomiting. Other symptoms include shortness of breath, confusion and coma.

• 4

  Conduct a clinical examination to determine the extent of the dehydration. A dry mouth, decreased skin turgor and sunken eyes are present at about 3 percent dehydration. Ketoacidosis frequently causes dehydration in the 5 to 10 percent range.

• 5

  Measure the pH level of the blood. A pH of less than 7.2 is considered moderate to severe ketoacidosis. Blood sugar should be checked at least hourly or more frequently if the insulin infusion rate is changed.