Diabetic ketoacidosis (DKA) is a potentially serious diabetes complication that can cause various symptoms. Doctors can use various laboratory tests to make DKA diagnoses. This includes an arterial blood gas (ABG) test that measures various components of blood. DKA occurs when the body is unable to use sugar and begins to break down fat for energy. This releases ketones into the blood, making it acidic. ABG, also known as blood gas analysis, is a test that measures blood pH and helps diagnose metabolic conditions. This article explains in detail how diabetic ketogenic acidosis (DKA) affects arterial blood gas (ABG).
What is diabetic ketoacidosis?
DKA is a serious complication that can occur in diabetics. This condition occurs when the body cannot use insulin or there is not enough of this hormone to convert blood sugar into energy. When this happens, the liver converts fat into the necessary energy and releases ketones into the bloodstream. When ketone levels are too high, blood becomes acidic. Changes in blood acidity can be life-threatening. According to medical experts, severe DKA levels can lead to diabetic coma or death. DKA can occur in type 2 diabetes patients, but it is more likely to affect type 1 diabetes patients. In general, DKA progresses slowly, and may begin to show various symptoms as follows.
· high blood sugar levels
· an intense thirst
· frequent urination
· Fatigue
· confusion
· a stomachache
· a blurred vision
· Nausea
· fruity breath
· Fainting
What is arterial blood gas test?
Arterial blood gas (ABG) testing is a type of blood test that measures various components of blood, such as:
· Oxygen
· carbon dioxide
· · pH
· bicarbonate
Medical professionals typically collect blood from arteries on the wrist and run it through an analyzer. ABG values may be out of normal range due to various medical conditions. Normal ABG values are as follows.
pH : 7.35~7.45
Oxygen level (PaO2): 75–100 millimeters of mercury (mmHg)
Carbon dioxide level (PaCO2): 35–45 mmHg
Bicarbonate (HCO3): 22–26 mm equivalent per liter (mEq/l)
Effects of DKA on ABG
In general, blood maintains a pH value of 7.35 to 7.45. Various factors such as the balance of alkalinity and acidity, and the balance of acid and base can cause changes in the figure. When someone gets DKA, ketones entering the bloodstream interfere with the balance of acids and bases and make the blood more acidic. Medical experts determine whether blood is acidic through the Henderson-Hasselbalch equation and Lewis model interpretation of biological acidosis. Medical experts consider high concentrations of positive hydrogen ions and low concentrations of bicarbonate ions acidic. The ABG test can also measure partial pressure. Carbon dioxide levels in the blood can serve as an indicator of ventilation. Acidosis generally causes a respiratory reaction. Therefore, ABG results of low pH and PaCO2 show metabolic acidosis such as DKA.
How does diabetes cause DKA?
Diabetes can lead to DKA when blood sugar levels are very high due to insulin deficiency. These low insulin levels cause physiological changes, including the breakdown of triglycerides and release of free fatty acids. The "liver" converts fatty acids into ketones and releases them into circulatory systems, which can be used as fuel in body tissues. Medical experts say diabetics can develop DKA for several reasons:
1. Lack of insulin
If the equipment is defective, such as insufficient insulin capacity, administering the wrong dose, or clogging the insulin pump, the body may lack insulin.
2. Not eating enough
Loss of appetite or skipping meals can lead to higher ketone levels.
3. Insulin reaction during sleep
Some people can also produce ketones while sleeping at night. This is generally caused by a reaction to insulin. According to medical experts, the following causes are included.
· Certain drugs, including diuretics and corticosteroids
· a heart attack or stroke
· physical injury
· Alcohol or drug use
DKA can be life-threatening, so it is important to prevent conditions. Medical experts say the risk of DKA can be reduced by:
· Monitor your blood sugar level often, especially when you're sick
· Take medication such as insulin according to prescription
· Maintain stable blood sugar levels within the target range as much as possible
· Consult a healthcare professional if blood sugar levels or insulin levels fluctuate significantly overnight
· Work with a doctor or diabetes educator to learn how to adjust insulin levels based on activity levels and food intake