Diabetes can cause acute and chronic complications. Acute complications include hypoglycemia, diabetic ketoacidosis, hyperglycemic hyperosmolar states. Chronic complications include micro-vascular complications like diabetic retinopathy, neuropathy and nephropathy and macro-vascular complications like coronary artery disease, peripheral arterial disease, cerebrovascular accidents.
DKA occurs predominantly in those with type 1 diabetes. The basic defect in the pathogenesis of DKA is insulin deficiency. Glucagon is a counter regulatory hormone which facilitates gluconeogenesis mechanism; hence hyperglycemia will occur. The absolute insulin deficiency and hyperglycemia leads to synthesis of ketone bodies such as acetoacetate and beta hydroxyl butyrate from hepatocytes, hence ketosis will occur. The precipitating factors for pathogenesis of DKA are sub optimal insulin dose, insulin or oral antidiabetic drugs omission, respiratory tract infections, genitourinary tract infection, etc and Cerebrovascular accidents such as ischemic and hemorrhagic stroke.
Author(s) Details:
Manjiri R. Naik,
Department of Medicine, MGM Medical College and Hospital, Aurangabad, India.
Shamisha Khade,
Department of Medicine, MGM Medical College and Hospital, Aurangabad, India.