Prognosis of Diabetic Ketoacidosis

By  , Expert Content
Jan 03, 2012

Diabetic ketoacidosis is a potentially life threatening complication of diabetes. Thousands of patients with diabetes die from diabetic ketoacidosis (DKA) every year. It is, however, a preventable complication and with proper and aggressive treatment, most people with diabetic ketoacidosis (DKA) may recover completely.


Prognosis of Diabetic Ketoacidosis


Death from DKA: Most people who develop DKA recover after treatment and only about 2% of patients die (when the condition is not treated properly). Prognosis or outcome of DKA is substantially worsened at the extremes of age (young children and elderly) and in the presence of coma and hypotension. Older patients may not be on insulin before developing DKA and therefore, are less likely to have had a history of an episode of DKA. Older patients usually need more insulin for the treatment of DKA, the hospital stay is usually longer and the death rate is also higher (22 percent for those older than 65 as compared with 2 percent for those younger than 65 years).

Complications of DKA: Some patients can develop complications from the treatment of diabetic ketoacidosis such as low blood sugar, low potassium, collection of fluid in the lungs (pulmonary edema), seizure, cardiorespiratory arrest or swelling of the brain (cerebral edema). Many of these complications are related to treatment used for diabetic ketoacidosis such as fluids and insulin.

  • Low blood sugar (hypoglycemia): If insulin therapy is given rapidly and the blood sugar is not monitored, the blood sugar levels can drop. If blood sugar level drops rapidly and significantly, you may develop low blood sugar.
  • Low potassium (hypokalemia): Insulin and fluid used for the treatment of DKA allows potassium to enter your cells. It may cause your potassium levels to drop to an extremely low level. Potassium is needed to maintain an appropriate function of heart, muscles and nerves. Low levels of potassium can impair the function of your heart, muscles and nerves.
  • Swelling in the brain (cerebral edema): If too much fluid is given rapidly or the blood sugar level is corrected too quickly, the brain may swell. It occurs most often in children, who were newly diagnosed with diabetes. In children and elderly, greater care is required while administering electrolytes, fluids and insulin owing to increased concern of cerebral edema with high fluid rates.


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