Quiz: What Do You Know About Diabetic Ketoacidosis?

Romesh Khardori, MD, PhD


December 03, 2015

Insidious increased thirst (ie, polydipsia) and urination (ie, polyuria) are the most common early symptoms of DKA. Malaise, generalized weakness, and fatigability also can present as symptoms of DKA.

Nausea and vomiting usually occur and may be associated with diffuse abdominal pain, decreased appetite, and anorexia. A history of rapid weight loss is a symptom in patients with newly diagnosed type 1 diabetes.

Patients may present with a history of failure to adhere to insulin therapy or missed insulin injections owing to vomiting or psychological reasons. Decreased perspiration is another possible symptom of DKA. Altered consciousness in the form of mild disorientation or confusion can occur. Although frank coma is uncommon, it may occur when the condition is neglected or if dehydration or acidosis is severe.

Among the symptoms of DKA associated with possible intercurrent infection are fever, dysuria, coughing, malaise, chills, chest pain, shortness of breath, and arthralgia. Acute chest pain or palpitation may occur in association with myocardial infarction. Painless infarction is not uncommon in patients with diabetes and should always be suspected in elderly patients.

For more on the presentation of DKA, read here.


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