Diabetic Ketoacidosis
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1 Form: D-8708 Diabetic Ketoacidosis For family, friends and caregivers of a patient with diabetic ketoacidosis in the Medical Surgical Intensive Care Unit (MSICU) This brochure will give you more information about: The causes and symptoms of diabetic ketoacidosis How diabetic ketoacidosis is treated in the MSICU What you can do to help
2 What is diabetic ketoacidosis? Diabetic ketoacidosis happens to people with diabetes, and mostly in people with type 1 diabetes. It happens when the body does not have enough insulin in the blood. When this happens, glucose (sugar) in the blood cannot be used as a fuel source for the body. Instead, fat is used for fuel instead of glucose. When fat is used, an acid called a ketone builds up in the body. Ketones in the body are poisonous at high levels. When high ketone levels increase, the blood becomes more acidic. This acid build up is called diabetic ketoacidosis or DKA. Diabetic ketoacidosis is a medical emergency. Without treatment it can lead to death. What are the signs and symptoms of diabetic ketoacidosis? Confusion Fruity smelling breath Vomiting More urine than usual Extreme thirst Very fast breathing 2
3 What can cause DKA? Reduced insulin production or the body becomes resistant to insulin Untreated diabetes or stopping the use of insulin if a person has diabetes A serious infection Swelling or infection of the pancreas How is DKA treated in the MSICU? Before treatment begins, several tests will be done. These tests may include: Blood tests Urine tests An electrocardiogram (ECG) to check the heart Some medications that may be used to treat DKA: Insulin to lower glucose or sugar levels in the blood Bicarbonate to help balance the acid in the blood Electrolyte replacements because insulin decreases potassium levels in the blood Large amounts of intravenous (IV) fluid Sedatives and pain medication to help keep your loved one comfortable and make being on a breathing machine (ventilator) easier Some treatments and tests that may also be used to help during DKA are: Close monitoring of blood glucose levels Frequent blood tests so we can adjust treatments when needed Antibiotics to treat infection Mechanical ventilation (breathing machine) 3
4 What can I do to help? Substitute Decision Maker It is important for one family member to act on behalf of their loved one as a Substitute Decision Maker (SDM). An SDM is usually the next of kin, unless the patient chooses someone else. As an SDM, you are responsible for giving accurate and honest information about your loved one to the health care team. You also: Partner with the health care team to make sure you understand what is happening with your loved one Work together with the team to decide about the care and treatment of your loved one Please look for the brochure Substitute Decision Makers and Naming an Attorney for Personal Care in the MSICU waiting room. Comfort and support Although sometimes patients in the MSICU are on sedating medication, they do still need emotional support from their friends or families. Talk to them like you would at home. Bring toiletries, familiar pictures, books and comforting items from home. Visiting hours Visiting hours are from 9:00 am to 11:00 pm every day, but we have a flexible visiting policy. Please talk to your nurse. Make sure only 2 people visiting your loved one at a time. Please try to keep your visits short and remember to let other family members in to visit. Consider limiting the number of visitors until your loved one is in stable condition. 4
5 Hand washing You can help the health care team, your loved one and yourself by washing your hands often during your visits to MSICU. Please follow all isolation instructions or talk to your nurse if you are not sure what to do when visiting an isolation room. Who can I talk to if I have questions? Do not be afraid to ask questions. Ask any member of the health care team to repeat or say information in a different way. You can talk with any of the medical staff caring for your loved one about any concerns you may have. More information about diabetic ketoacidosis? Organization: Mayo Clinic Diabetic ketoacidosis Organization: Medline Plus Diabetic ketoacidosis Organization: Diabetes Canada Visit for more health information. Contact us to provide feedback or request this brochure in a different format, such as large print or electronic formats: pfep@uhn.ca 2018 University Health Network. All rights reserved. Use this material for your information only. It does not replace advice from your doctor or other health care professional. Do not use this information for diagnosis or treatment. Ask your health care provider for advice about a specific medical condition. You may print 1 copy of this brochure for non-commercial and personal use only. Form: D-8708 Author: Ingrid Daley, Dr. John Granton, Elke Ruthig Created: 09/2018
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