Case Study: Diabetic KetoacidosisKimberly Schaible

Consider the Following Patient

Jason is 54 year-old who has had Type 1 diabetes since he was 6 years-old. Recently, he has been experiencing vague abdominal pain and nausea but no vomiting. He presents today at the emergency room a distinct fruity odor on his breath and complains that his blood sugars have been elevated more than normal. He also appears pale and complains of being very tired.

What is Jason’s initial diagnosis?What tests would help verify this

diagnosis?

Jason’s Blood Test Results

Case Study

Diabetic Ketoacidosis is characterized by: Increased blood sugars over 250mg/dl Distinct fruity odor of breathAppear dehydrated and weakVague abdominal painNausea and vomiting Increased thirst and urination

Lab Test Results

Lab Tests:Metabolic Profile

Low pH, low bicarbonate levels, low sodium levels, high glucose levels, high potassium levels, high creatine/BUN, high anion gap

Complete Blood Count (CBC) Normal to elevated white blood cell count,

elevated hemoglobin level

Lab Test Results

Serum Ketone Test Positive

HgbA1c Normal to elevated (indicator of how diabetes is

being controlled)Arterial pH

Low

Biochemistry of DKA

How do you treat DKA?

How DKA Affects Me

The case study patient, Jason, is actually my uncle. Both my aunt and uncle have Type 1 diabetes had have suffered diabetic ketoacidosis as a complication of their diabetes. If untreated, diabetic ketoacidosis can be life-threatening. However, with the right care and maintenance (of diabetes), the patient can treat diabetic ketoacidosis.