Diabetic ketoacidosis history and symptoms
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A positive history of type 1 diabetes mellitus, infection and history of poor compliance to insulin regimens are suggestive of diabetic ketoacidosis (DKA). The most common symptoms of DKA include extreme tiredness, vomiting, abdominal pain, fruity smell of breath, weight loss and polyuria.
Age of onset
- Young children (age less than or equal to 2 years) tend to present more likely with DKA as the first presentation of type 1 diabetes than older children.
- Peripubertal and adolescent girls are affected more than other age groups.
- Families harboring HLA-associated high-risk genotypes are associated with a high chance of presenting DKA at diabetes onset.
- Patients who have a family history of type 1 diabetes have less chance of developing DKA, possibly due to increased awareness of the disorder.
- Patients may present with a history of poor compliance with insulin therapy or missed insulin injections due to vomiting or psychological reasons.
Past medical history
- DKA is associated with a past medical history of type 1 diabetes.
- Type 2 diabetics may rarely develop DKA at a late stage of the disease due to failure of beta pancreatic cells.
- History of infections (for example, urinary tract infections, pneumonia in an individual suffering from type 1 diabetes.
- Patients may have a history of use of illicit drugs, for example, alcohol and cocaine.
- Patients may have poor socioeconomic status, which contributes to poor medication adherence in diabetics.
- Sluggish, extreme tiredness
- Fruity smell to breath/compare to nail polish remover
- Extreme thirst, despite large fluid intake
- Constant urination
- Extreme weight-loss
- Oral Thrush may be present, or/ yeast infections that fail to go away, this is because the normal fungal/flora present in oral cavity/cervix in women, the balance is upset and bacterial began to feast on the high sugar from urine output/ dry mouth from extreme thirst.
- Muscle wasting
- Agitation / Irritation / Aggression / Confusion
- Emesis (vomiting), although this is not always a sign of late-stage ketoacidosis, and can occur both in early-stage ketoacidosis and in non-ketoacidic hyperglycaemia.
- Abdominal pain
- Loss of appetite
- Flu-like symptoms
- Lethargy and apathy
- Extreme weakness
- Kussmaul breathing ("air hunger"). Patients breathe more deeply and/or rapidly.
- Unconsciousness (diabetic coma) after prolonged DKA. At this stage, speedy medical attention is imperative.
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