Diabetic Ketoacidosis (DKA) Pathophysiology, Animation

Diabetic ketoacidosis (one of the hyperglycemic crises), DKA, pathophysiology, causes, clinical presentation (signs and symptoms) and treatment.
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Diabetic ketoacidosis, DKA, is an ACUTE and potentially life-threatening complication of diabetes mellitus. DKA is commonly associated with type 1 but type 2 diabetics are also susceptible. DKA is caused by a critically LOW INSULIN level and is usually triggered when diabetic patients undergo further STRESS, such as infections, inadequate insulin administration, or cardiovascular diseases. It may also occur as the FIRST presentation of diabetes in people who did NOT know they had diabetes and therefore did NOT have insulin treatment.
Glucose is the MAJOR energy source of the body. It comes from digestion of carbohydrates and is carried by the bloodstream to various organs. Insulin is a hormone produced by beta-cells of the pancreas and is responsible for DRIVING glucose INTO cells. When insulin is DEFICIENT, glucose can NOT enter the cells; it stays in the blood, causing HIGH blood sugar levels while the cells are STARVED. In response to this metabolic starvation, the body INcreases the levels of counter-regulatory hormones. These hormones have 2 major effects that are responsible for clinical presentation of DKA:
- First, they produce MORE glucose in an attempt to supply energy to the cells. This is done by breaking down glycogen into glucose, and synthesizing glucose from NON-carbohydrate substrates such as proteins and lipids. However, as the cells CANNOT use glucose, this response ONLY results in MORE sugar in the blood. As blood sugar level EXCEEDS the ability of the kidneys to reabsorb, it overflows into urine, taking water and electrolytes along with it in a process known as OSMOTIC DIURESIS. This results in large volumes of urine, dehydration and excessive thirst.
- Second, they activate lipolysis and fatty acid metabolism for ALTERNATIVE fuel. In the liver, metabolism of fatty acids as an alternative energy source produces KETONE bodies. One of these is acetone, a volatile substance that gives DKA patient’s breath a characteristic SWEET smell. Ketone bodies, unlike fatty acids, can cross the blood-brain barrier and therefore can serve as fuel for the brain during glucose starvation. They are, however, ACIDIC, and when produced in LARGE amounts, overwhelm the buffering capacity of blood plasma, resulting in metabolic ACIDOSIS. As the body tries to reduce blood acidity by EXHALING MORE carbon dioxide, a deep and labored breathing, known as Kussmaul breathing may result. Another compensation mechanism for high acidity MOVES hydrogen ions INTO cells in exchange for potassium. This leads to INcreased potassium levels in the blood; but as potassium is constantly excreted in urine during osmotic diuresis, the overall potassium level in the body is eventually depleted. A blood test MAY indicate too much potassium, or hyperkalemia, but once INSULIN treatment starts, potassium moves BACK into cells and hypokalemia may result instead. For this reason, blood potassium level is monitored throughout treatment and potassium replacement is usually required together with intravenous fluid and insulin as primary treatment for DKA.

[@Alilamedicalmedia]

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[@medicineislove148]

this was absolutely the best explanation on dka i ever came across. had never been able to understand it from lectures, self reading, or other videos. yr channel is the best. thank you .

[@dr.roshan4352]

Indeed

[@tashi.ahmad246]

9q

[@Jcruzinfit]

Agreed

[@darrenfitzgerald8354]

💯

[@imnotwatchin]

Great Explanation.. Also makes me marvel how our bodies are designed..this is absolutely divine !!

[@ThelmaOnuoha]

Simply the best video on DKA 👍

[@Alilamedicalmedia]

Wow, thanks!

[@raynaboyarsky4591]

thank you!!!

[@lecat5674]

Wow... thank you...

[@sarah_muwafaq]

Thanx for vedio

[@Quantum8shift]

Pharmacology videos please

[@olamachala]

Who is at risk of diabetes?

[@dorajona6627]

Type 1 DM Uncontrolled DM Infections in a pt with DM

[@تباركحيدرعباس]

Obesity, genetics

[@divamarakua586]

This video is saving me from crying of hopelessness rn

[@mistergq1774]

Absloutely the BEST , short , sweet and to the point. Very well done !

[@TheAmmarKeylani]

I like your videos because they cut straight into the axis of the subject and don't loiter around in uncertainty as many do. I wish you could cover the relationship between high glucose in the blood with the effect it has on blood brain barrier resulting in metabolic acidosis and such effect on amyloid beta protein activity in Alzheimer! This Triangle I have been trying to put together lately and in need to verify!

[@banana.m3462]

I went into dka yesterday . Had to go straight to a and e then got discharged this morning. it was scary

[@aporifera]

I'm here because I've been struggling with ketones since I've been diagnosed with Type 1 Diabetes. I've been managing everything that enters my mouth, food to the gram and 2.7QT of water per day, and I have not had 250+ or 70- for 5 days. I'm also on a pump so there should never be a lack of insulin. Yet I'm STILL getting ketones in the higher range (high according to my test strips but not to the point of DKA). No starvation, no dehydration, no lack of insulin, no hyperglycemia, no infection, so why? Could anyone please help me with a POSSIBLE explanation? Thanks!

[@saigehartert4876]

Hi sorry this is very delayed but maybe your ketone strips are expired? I used some one time that “went bad” and it said I had large ketones but in reality they were actually trace.

[@matrich1983]

Hi, what's mainly your diet? Wondering if it could possibly be nutritional ketosis?

[@muqtarjamaegal6071]

Stress maybe becouse you are more stressfull

[@afrinaziz1794]

Excellent explanation...clearly understood the pathology

[@drsultansaudagar2733]

I would love to watch video on bleeding time clotting time prothrombin time and its significance.

[@MikeB-sp6gp]

Suggested topic: "The 3 P's" is often cited as signs of hyperglycemia. Polyuria is often readily evident in acute hyperglycemia-- and the relationship between polyuria and polydipsia is easy to understand. The "third P" however, polyphagia, isn't as easy to understand-- and, in my experience as an RN, I didn't observe acute increased hunger in patients with acute hyperglycemia. On the other hand, I frequently observed chronic polyphagia in patients with chronic hyperglycemia. -- A video on "the 3 Ps" that explained the pathophysiology of hyperglycemia-related polyphagia would be great. I also want to thank you for your terrific videos. They are, without any equals, the best quick video summaries about pathophysiology on the Internet. Your explanations are always cleanly presented, clarified by terrific animation, and focused on relevant issues.

[@TravelnurseMercy81]

Cells are starving you have no energy you want carbs to eat to produce energy in hyperglycemia, but also remember once you get to DkA you’ve been feeling hungry and thirsty but now in DKA you are nauseous, stomach ache you don’t feel hungry or even if you do you can’t eat. Diabetic RN here

[@daniellemartin5111]

Best explanation!! I needed a refresher! Glad I found this video!

[@sajedahaisam9135]

Amazing video, thank you for explaining everything smoothly

[@mariselavarelarussian7021]

Suggested topic. Going dip into how high levels of sugar gets a person into a diabetic coma and what happens in the organs once in the coma.

[@tongtongshi3433]

this was absolutely the best explanation on dka i ever came across. had never been able to understand it from lectures, self reading, or other videos. yr channel is the best. thank you .

[@Alilamedicalmedia]

Glad it helped!

[@alecdeflorio9941]

I've almost died several times insurance wouldn't fill my insulin my sugar climbed to 1200and I couldn't speak or talk coherently couldn't keep water down and my skin and eyes turned yellow

[@rahulsadiq56]

can anyone tell me if our body is breaking fat for energy than fat broken down to glucose how that is used by body because their is not enough insulin

[@KK-nm8lf]

Pls make videos on pharmacology

[@SteezySteez2011]

Fantastic video. Summed up my entire AEMT school section on DKA in minutes

[@naimhazierah5531]

Thnk you. You explain it in a really simple way. I really appreaciate it

[@spshivani6828]

Best tutorial of this topic 👍👍👍👍👍 amazing thanku dear

[@lydia373]

thanks! explained calmly and systematically. nice animation also :)

[@wiamalbouzidi8362]

thank you very much, from a med student in belgium !

[@rohithgaiba1906]

Cvs topics

[@Massa27580]

I appreciate easy way with big effort

[@mahaqalbani4867]

Excellent video. Brief, concise and comprehensive 👍

[@RadhaKrishnaa1videos]

So helpful thank you

[@oliversandeep]

its an amazing learning experience , thanks alila

[@yusifalhassan7279]

Thank you very much And please I want a full video on diabetics as whole topic. Thank you once again.and may Allah bless you abundantly Ameen

[@radharamana9038]

Excellent.. Please present a vedio on diabetic management during emergency & ellective surgery..thank you.

[@dilipkale2140]

Pl also tell the exercises for diabetic kitoacidosis.

[@ELMV403]

Very nice explanation

[@christinetompkins1470]

This is a great video, thanks so much

[@brenyboy26]

fuck this was good. why can't lectures be this good? Must we know all the fairy parts? OR is it because we know all the fairy parts from our lectures, that we are able to watch this video with such ease, and synthesise the information easily thereby suggesting that this presentation is better than a lecture? Thoughts...

[@doctorbase2364]

Extremely awesome , god bless ya team

[@sravanimadduluru]

The best pathophysiology ever

[@afridaafroz4192]

one of the best tutorials on DKA so far

[@sunwm2003]

If this whole theory is true, then why the people on carnivore are thriving not dying?

[@jameshawes1758]

Not a theory you idiot it's biology

[@AnjorinOmotola]

How do you like to be hugged?❤❤❤

[@utibepeter9585]

❤❤very detailed and clear explanation

[@arifbhat5015]

Best way of explanation....

[@veronicabanda5217]

Wow,this has cleared the confusion I had concerning this topic . Perfect video , indeed!

[@bettymosenye8471]

Beautifully covered 🙌👌

[@wesamblall5972]

Thank you for informitions

[@maheedhararavi8145]

Thanks. I am a layman in medical field. I like to know how heat is generated in body. Which type of energy our body systems use.

[@GagaMauya]

Where can I find this explaintion in writing? Please

[@Alilamedicalmedia]

In the video description.

[@miancu3]

Great animation of the potassium imbalance issue, thank you.

[@jasonhumphries9434]

A very useful video that was clear & easy to understand. Thank you for sharing. 👍

[@kokocipher]

Nice video, I finally understood why Acidosis is associated with DM

[@dayo.s2512]

very helpful thank you

[@Mohammad-xe2qw]

Brain does NOT need ketones,it can still utilize glucose because it's insulin independent.

[@KA-co4vb]

Very helpful video

[@cognizenutrition5244]

Very nice

[@IrfanAli-jg7nr]

Make video on hypertension, nd kindly give more focus on treatment nd prognosis

[@raphaellekoerber1875]

Well done, thank-you

[@Iafnnan]

THANK YOU!

[@sid32ful]

Can stress cause diabetes?

[@apsaribegum7257]

Amazing

[@tendeant]

Thank you for this! Clear, concise and with animations.

[@princeyeboah9634]

Absolutely remarkable explanation. God bless you Ma

[@drsheikh]

Excellent thanks

[@KA-co4vb]

Kindly share video on fluid replacement therapy in DKA

[@OlafThorbjorn]

Excellent

[@elwadia1760]

Great 💜

[@ramchandrasuthar2848]

Very nice analysis

[@raniamethia7278]

thank you

[@leonanarine7891]

Hey can I use this video in my Dka presentation

[@Alilamedicalmedia]

Please see the "About" tab of our channel for information regarding this.

[@leonanarine7891]

@@Alilamedicalmedia thank you

[@waleedov5963]

Great

[@sanaaahmed4730]

Amazing ❤️🫡

[@MerazHashmi-x3h]

Loved it 💥👍

[@mmcharg4655]

Short and precise. Just the way I like it😊

[@chimwemwechanda5898]

this video is helping and talk about how to prevent the same

[@yamamasajed6341]

BEST BEST BEEEEEST

[@BasiimaSamuel-xo9vq]

Heart failure

[@استغفراللهالعظيمواتوباليه-ظ5ث]

Thanks

[@drsasibrucefitness2889]

Information is very clear. Thank you so much for making easy to understand

[@Alilamedicalmedia]

Glad it was helpful!

[@Oak.9]

Thank you

[@VoLk0n0v28]

I do have DKA

[@ebtehalfedal4502]

❤❤❤❤❤❤❤

[@millolailyang1545]

TYSM

[@lowenherz2739]

please make a video on Metabolic Response to trauma

[@sarahsarah9864]

❤❤❤❤❤❤❤❤❤❤❤

[@marieclaire3449]

Choices of iv fluids replacement. Thanks

[@ricardotorres3709]

Excellent

[@venkybly]

Tq

[@sama273]

❤❤❤❤

[@adannaoparah7268]

Please can you cover pathophysiology of Monkeypox. Thanks.

[@Alilamedicalmedia]

Not much known about pathophysiology of monkeypox, we have a video about monkeypox basics here: kzbin.info/www/bejne/oaHMqXVjh9eCkM0

[@comfortmmatlala9593]

Pathophysiology of hyperthyroidism please

[@kaziyaad8258]

please make a video on acute mountain sickness

[@Fallenparts]

Can someone explain it in more easy words

[@alianaz4127]

Please cover the management of ckd

[@natasha1394]

Very good explanation thanks a lot

[@adomgrace-zj5ym]

Please make a video on lactic acidosis

[@erikajimenez7207]

SO HELPFUL! thank you