How to help your patients with Diabetic Ketoacidosis

With an increasing number of people managing COVID-19 from home, I have seen numerous ER doctors on social media mentioning a "serious and life-threatening condition that they are seeing frequently in hospitals: Diabetic Ketoacidosis (DKA). 

A quick summary with some helpful resources:

Diabetic Ketoacidosis is most common with Type 1 diabetes, but can also occur in Type 2 diabetes, especially for those who are on certain classes of medications and/or insulin. 

With diabetes, even mild illness (including COVID-19) can lead to dangerously high blood sugar. People living with diabetes may see a sudden increase or spike in their blood sugar during illness – it's important to test more often – every 3-4 hours or so to monitor. Alberta Health features a good summary of sick day guidelines for people living with diabetes.

What are the signs and symptoms of DKA?

DKA usually develops slowly. Early symptoms include:
Being very thirsty
Urinating a lot more than usual

If untreated, more severe symptoms can appear quickly, such as:

Fast, deep breathing
Dry skin and mouth
Flushed face
Fruity-smelling breath
Headache
Muscle stiffness or aches
Being very tired
Nausea and vomiting
Stomach pain.

Patients with diabetes who are sick may change their eating habits, and/or their fluid consumption, and fevers may cause increased sweating. All of these things can affect blood sugar. Medications may need to be adjusted as well. 

As the CDC states, patients should go to the ER or call 911 right away if they can’t get in touch with their physician and have any of the following:

Blood sugar staying at 16.7mmol/L or above
Breath that smells fruity
Vomiting & can’t keep food/drinks down
Trouble breathing
Multiple symptoms of DKA. 

If you have a friend or family member who is a Type 1 or Type 2 diabetic, it might be good to remind them of this as we are seeing widespread COVID-19 in the community and also other viruses this winter.

Check out this great infographic from Diabetes Canada

I have also shared this post on the Friendly Pharmacy 5 account on Instagram.

And Friendly Pharmacy 5 on Facebook