What Causes Ketoacidosis?
May 07, 2021
Source: Cainiu Health
Dr. He Liangjun
Introduction
What Causes Diabetic Ketoacidosis (DKA)?
Acute infections: A major precipitating factor for DKA, including respiratory, urinary, and cutaneous infections. Acute infections may also occur as complications of DKA.
Inadequate treatment: Such as discontinuation of medications—particularly insufficient insulin dosing or development of insulin resistance—especially in patients with type 1 diabetes who stop or reduce their insulin therapy.
Diabetic ketoacidosis (DKA) refers to a pathological condition occurring in diabetic patients under various precipitating factors, characterized by marked insulin deficiency, inappropriate elevation of counter-regulatory hormones, and consequent hyperglycemia, ketonemia, dehydration, electrolyte disturbances, metabolic acidosis, and even coma.
Common precipitating causes include:
Acute infection: Acute infection is a major precipitant of DKA, including respiratory, urinary tract, and skin infections. Conversely, acute infection may also occur as a complication of DKA; the two conditions often interact causally, creating a vicious cycle that further complicates diagnosis and management.
Inadequate or inappropriate treatment: This includes discontinuation of medications—particularly insulin therapy—as well as insufficient dosing or development of insulin resistance. Notably, cessation or reduction of insulin therapy in patients with type 1 diabetes frequently triggers DKA. In patients with type 2 diabetes, prolonged high-dose administration of phenformin (a biguanide) — especially in the presence of impaired hepatic or renal function — predisposes to DKA. Cases of DKA induced by high-dose thiazide diuretics have also been reported.
