From the Guidelines
Diabetic ketoacidosis (DKA) and kerosine are two completely unrelated substances, with DKA being a serious medical complication of diabetes and kerosine being a toxic and flammable hydrocarbon liquid with no medical use. DKA is a life-threatening condition that occurs when the body produces high levels of blood acids called ketones due to insufficient insulin, leading to symptoms such as excessive thirst, frequent urination, nausea, abdominal pain, weakness, fruity-scented breath, confusion, and in severe cases, coma 1. The management of DKA involves restoration of circulatory volume and tissue perfusion, resolution of hyperglycemia, and correction of electrolyte imbalance and acidosis, with individualization of treatment based on a careful clinical and laboratory assessment 1.
- Key treatment goals for DKA include:
- Restoration of circulatory volume and tissue perfusion
- Resolution of hyperglycemia
- Correction of electrolyte imbalance and acidosis
- Treatment of any underlying cause of DKA, such as sepsis, myocardial infarction, or stroke
- In contrast, kerosine is a fuel that should be handled with appropriate safety precautions and kept away from the body, as it is toxic if ingested, inhaled, or absorbed through skin contact.
- The use of bicarbonate in patients with DKA has been shown to make no difference in the resolution of acidosis or time to discharge, and its use is generally not recommended 1.
- Successful treatment of DKA requires continuous intravenous insulin in critically ill and mentally obtunded individuals, with a transition to subcutaneous insulin requiring administration of basal insulin 2–4 h before the intravenous insulin is stopped to prevent recurrence of ketoacidosis and rebound hyperglycemia 1.
From the Research
Diabetic Ketoacidosis
- Diabetic ketoacidosis is a serious complication of diabetes that can be life-threatening if not treated properly 2, 3, 4.
- It is characterized by hyperglycemia, metabolic acidosis, and ketosis 3, 5.
- The principal causes of diabetic ketoacidosis include insulin deficiency, stress hormone excess, dehydration, and fasting 2.
- Infection is the most common precipitating cause of diabetic ketoacidosis, but stress in any form can lead to metabolic decompensation 2, 3.
Treatment and Management
- The treatment of diabetic ketoacidosis includes hospitalization for aggressive intravenous fluids, insulin therapy, electrolyte replacement, and identification and treatment of the underlying precipitating event 3, 5.
- Low-dose insulin therapy, rehydration with isotonic saline, and aggressive potassium replacement are recommended 2, 6, 4.
- The use of bicarbonate is controversial and should be restricted to patients with an arterial pH of less than 7.0 and/or a patient in cardiogenic shock 2, 6.
Prevention
- Prevention of diabetic ketoacidosis is mandatory to reduce mortality rates 2, 3.
- Patient education and instructions for the patient to contact the physician early during an illness can help prevent diabetic ketoacidosis 3, 4.
- Future episodes of diabetic ketoacidosis can be reduced through patient education programs focusing on adherence to insulin and self-care guidelines during illness and improved access to medical providers 3.
Comparison with Kerosine
- There is no direct comparison between diabetic ketoacidosis and kerosine in the provided studies.
- Diabetic ketoacidosis is a medical condition, while kerosine is a type of fuel, and they are not related in the context of the provided studies.