clinical features of diabetic ketoacidosis
Last reviewed 01/2018
Clinical presentation of DKA may vary according to the severity and comorbid conditions. The symptoms of diabetic ketoacidosis (DKA) usually develop rapidly over 1 day or less and may include:
- polyuria with polydipsia – commonest presenting symptom
- weight loss
- fatigue
- dyspnea
- vomiting
- preceding febrile illness
- abdominal pain
- polyphagia
Patients may have tachycardia, poor skin turgor, dry mucous membranes, and orthostatic hypotension due to dehydration (1).
Deep (Kussmaul) respirations are seen as a compensatory mechanism for metabolic acidosis (1)
If severely ill, extreme cases may progress to shock, oliguria and anuria.
The breath may have a distinctive fruity smell - ketotic breath; however the ability to detect this smell is absent is a sizeable proportion of the population - and, by extrapolation, the medical population.
Mental status of patient may vary from confusion, drowsiness, progressive obtundation to loss of consciousness and coma (1,2)
Note:
- nausea, vomiting, and abdominal pain that may mimic an acute abdominal condition
- DKA may rarely be precipitated by sepsis, and fever is not part of DKA
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