Ketoasidoosi

Ketoasidoosi, commonly known as ketoacidosis, is a metabolic disorder characterized by elevated concentrations of ketone bodies in the blood, leading to a decrease in blood pH. The condition primarily occurs when insulin activity is insufficient, causing the body to metabolize fat for energy and produce acidic ketones as by‑products.

The most frequent form is diabetic ketoacidosis (DKA), which affects individuals with type 1 diabetes and, less commonly, those with type 2 diabetes under severe stress. Non‑diabetic ketoacidosis can develop in the context of prolonged fasting, excessive alcohol intake (alcoholic ketoacidosis), or a very low‑carbohydrate, high‑fat diet (nutritional ketoacidosis). Underlying triggers include infection, myocardial infarction, trauma, substance abuse, and certain medications such as sodium‑glucose cotransporter‑2 inhibitors.

Clinical presentation typically includes polyuria, polydipsia, abdominal pain, nausea, vomiting, and rapid breathing (Kussmaul respiration). Laboratory findings reveal hyperglycemia (in DKA), elevated serum ketone levels, low bicarbonate, and an arterial pH below 7.3. Diagnosis is confirmed by blood gas analysis and measurement of beta‑hydroxybutyrate.

Management centers on rapid fluid replacement, insulin therapy to suppress ketogenesis, and correction of electrolyte disturbances, particularly potassium. Identification and treatment of precipitating factors are essential to prevent recurrence. With prompt intervention, mortality rates are low, but delayed treatment can lead to cerebral edema, arrhythmias, or shock. Epidemiologically, DKA accounts for a significant proportion of diabetes‑related emergency admissions worldwide, emphasizing the need for patient education and optimal glycemic control.