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DIABETIC KETOACIDOSIS

When to Seek Medical Care

When to call the doctor

  • If you have diabetes, contact your doctor if you have very high blood sugars (generally more than 350 mg) or moderate elevations that do not respond to home treatment.
  • If you have diabetes and develop a fever or start vomiting, contact your doctor for instructions.
  • If you have home access to urine ketone test strips, and if urine sampling indicates moderate or greater urine ketones, notify your doctor.
When to go to the hospital

People with diabetes should be taken to the hospital's emergency department if they appear significantly ill, dehydrated, confused, or very weak. Other reasons to seek immediate medical treatment include Shortness of breath, chest pain, severe abdominal pain  with vomiting, and high fever.

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Self-Care at Home

Home care is generally directed toward preventing diabetic ketoacidosis and treating moderately elevated high blood sugar.

If you have type 1 diabetes, you should monitor your blood sugars at least 3-4 times a day. Check these levels more often if you feel ill, if you are fighting an infection, or if you have had a recent illness or injury.

Treat moderate elevations in blood sugar with additional injections of a short-acting form of insulin. Many people with diabetes have previously arranged with their physicians a regimen of extra insulin injections for home treatment if blood sugar levels begin to rise.

Be on the watch for signs of infection and keep yourself well hydrated by drinking non-sugary fluids throughout the day.

Follow-up

In mild cases of diabetic ketoacidosis, you may be treated and released from the emergency department providing that you will promptly follow up with your doctor.

Whether you are released and sent home or monitored in the hospital, it is important that close monitoring of blood sugars be continued at home. Most authorities suggest blood sugars be aggressively monitored and treated with testing done at least 4 times a day. Elevated blood sugars should be controlled with adjustable doses of insulin, and particular attention should be paid to drinking plenty of nonsugary fluids.

Long-term follow-up should include periodic follow-up with your doctor to achieve normal control of blood sugars and screen for and treat the complications of diabetes by periodic blood testing of hemoglobin A1C, kidney function and cholesterol, annual eye examination, and regular inspection of the feet for evidence of wounds or damage to nerves.

Prevention

Steps to prevent diabetic ketoacidosis include close monitoring and control of blood sugars, especially during times of infection,stress , trauma, or other serious illness; taking insulin injections on time; and contacting the physician when needed.

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