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Causes of Diabetic Ketoacidosis
List of causes of Diabetic Ketoacidosis
Following is a list of causes or underlying conditions (see also Misdiagnosis of underlying causes of Diabetic Ketoacidosis) that could possibly cause Diabetic Ketoacidosis includes:
More causes: see full list of causes for Diabetic ketoacidosis
Causes of Diabetic Ketoacidosis (Diseases Database):
The follow list shows some of the possible medical causes of Diabetic Ketoacidosis that are listed by the Diseases Database:
- Diabetes mellitus type 1
- Glucose transporter type 1 deficiency
- Malonyl-CoA decarboxylase deficiency
- Propionic acidaemia type 2
- Isovaleric acidaemia
- Glycogenosis type 3
- Diabetic ketoacidosis
- Methylmalonic aciduria type 2
- Starvation (acute)
- Glycogenosis type 6
- Fructose-1, 6-diphosphatase deficiency
- Glycogenosis type 1a
- Propionyl-CoA carboxylase deficiency
- Aspirin
- Acetylcysteine
- Phenylalanine hydroxylase deficiency
- Valproic acid
- Ethanol
- Nicotinic acid
- Methionine
Causes of Diabetic Ketoacidosis: Online Medical Books
16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the causes of Diabetic Ketoacidosis.
Hyperglycemia:
Differential Diagnosis
(In a Page: Signs and Symptoms)
- Impaired fasting glucose
-
Medications
–Corticosteroids are a common cause
–Common medications include growth hormone, estrogen (including oral contraceptives), nicotinic acid, salicylates and NSAIDs, thiazide and loop diuretics, phenytoin, and epinephrine - Diabetes mellitus type I
–Diabetic ketoacidosis - Diabetes mellitus type II
-
Pancreatic disease
–Acute or chronic pancreatitis
–Pancreatectomy
–Pancreatic carcinoma
–Hemochromatosis
–Cystic fibrosis -
Increased counter-regulatory hormones associated with acute disease
–Myocardial infarction
–Stroke or other neurologic disease
–Renal insufficiency
–Hepatic insufficiency - Acromegaly
- Cushing's syndrome
- Pheochromocytoma
- Hyperthyroidism (thyroid storm)
- Glucagonoma
- Gestational diabetes
- Amyloidosis
Hyperglycemia:
Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)
- Type I diabetes mellitus
–Most common form of diabetes in children
–Prevalence: 1.9/1,000
–Autoimmune-mediated destruction of pancreatic islets (β-cells)
–Absolute insulin deficiency
–Often presents with ketosis and DKA
- Type II diabetes mellitus
–Increasing prevalence in children, especially among obese
–In children, onset usually in mid-puberty
–More frequent in blacks, Hispanics, Pacific Islanders, Asians, and Native Americans (Pima Indians)
–Strong association with family history of type II diabetes
–Insulin resistance and inadequate insulin secretion results in relative insulin deficiency
-
Maturity-onset diabetes of the young (MODY)
–Infrequent
–Autosomal dominant disease
–Onset usually between 9 and 25 years old
–Genetic defects in enzymes or nuclear transcription factors involved in islet cell development or the regulation of insulin secretion -
Drug- or chemical-induced diabetes
–Glucocorticoids, β-adrenergic agonists, phenytoin, asparaginase, cyclosporine, tacrolimus, vacor, pentamidine, diazoxide, nicotinic acid, thyroid hormone, thiazides - Other endocrinopathies: Cushing disease, acromegaly, pheochromocytoma
-
Exocrine pancreatic diseases
–Cystic fibrosis
–Hemochromatosis - Pancreatectomy
- Physiological stress (trauma, infection)
-
Infections
–CMV
–Congenital rubella - Genetic syndromes: Prader-Willi syndrome, Down syndrome, Turner syndrome, Klinefelter syndrome, Wolfram syndrome
Breath with fruity odor:
Medical causes
(Handbook of Signs & Symptoms (Third Edition))
❑ Anorexia nervosa. Severe weight loss associated with anorexia nervosa may produce fruity breath, usually with nausea, constipation, and cold intolerance as well as dental enamel erosion and scars or calluses in the dorsum of the hand, both related to induced vomiting.
❑ Ketoacidosis. Fruity breath odor accompanies alcoholic ketoacidosis, which is usually seen in poorly nourished alcoholics with vomiting, abdominal pain, and only minimal food intake over several days. Kussmaul's respirations begin abruptly and accompany dehydration, abdominal pain and distention, and absent bowel sounds. Blood glucose levels are normal or slightly decreased.
With diabetic ketoacidosis, fruity breath odor commonly occurs as ketoacidosis develops over 1 to 2 days. Other findings include polydipsia, polyuria, nocturia, a weak and rapid pulse, hunger, weight loss, weakness, fatigue, nausea, vomiting, and abdominal pain. Eventually, Kussmaul's respirations, orthostatic hypotension, dehydration, tachycardia, confusion, and stupor occur. Signs and symptoms may lead to coma.
Starvation ketoacidosis is a potentially life-threatening disorder that has a gradual onset. Besides fruity breath odor, typical findings include signs of cachexia and dehydration, a decreased LOC, bradycardia, and a history of severely limited food intake (anorexia nervosa).
Other causes
❑ Drugs. Any drug known to cause metabolic acidosis, such as nitroprusside and salicylates, can result in fruity breath odor.
❑ Low-carbohydrate diets. These diets, which encourage little or no carbohydrate intake, may cause ketoacidosis and the resulting fruity breath odor.
Diabetes mellitus:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
DM affects an estimated 6% of the population of the United States, about half of whom are undiagnosed. Incidence is greater in females and rises with age. Type 2 accounts for 90% of cases.
In type 1 diabetes, pancreatic beta-cell destruction or a primary defect in beta-cell function results in failure to release insulin and ineffective glucose transport. Type 1 immune-mediated diabetes is caused by cell-mediated destruction of pancreatic beta cells. The rate of beta-cell destruction is usually higher in children than in adults. The idiopathic form of type 1 diabetes has no known cause. Patients with this form have no evidence of autoimmunity and don’t produce insulin.
In type 2 diabetes, beta cells release insulin, but receptors are insulin-resistant and glucose transport is variable and ineffective. Risk factors for type 2 diabetes include:
❑ obesity (even an increased percentage of body fat primarily in the abdominal region); risk decreases with weight and drug therapy
❑ lack of physical activity
❑ history of GDM
❑ hypertension
❑ Black, Hispanic, Pacific Islander, Asian American, Native American origin
❑ strong family history of diabetes
❑ older than age 45
❑ high-density lipoprotein cholesterol of less than 35 or triglyceride of greater than 250
❑ Seriously impaired glucose tolerance (IGT) test.
The “other specific types” of DM result from various conditions (such as a genetic defect of the beta cells or endocrinopathies) or from use of or exposure to certain drugs or chemicals. GDM is considered present whenever a patient has any degree of abnormal glucose during pregnancy. This form may result from weight gain and increased levels of estrogen and placental hormones, which antagonize insulin.
Insulin transports glucose into the cell for use as energy and storage as glycogen. It also stimulates protein synthesis and free fatty acid storage in the fat deposits. Insulin deficiency compromises the body tissues’access to essential nutrients for fuel and storage.
Severe weight loss associated with anorexia nervosa may produce fruity breath odor, usually with nausea, constipation, and cold intolerance. Induced vomiting may cause dental enamel erosion and scars or calluses in the dorsum of the hand.
Fruity breath odor accompanies alcoholic ketoacidosis, which is usually seen in poorly nourished alcoholics with a history of vomiting, abdominal pain, and only minimal food intake over several days. Kussmaul’s respirations begin abruptly and accompany dehydration, abdominal pain and distention, and absent bowel sounds. Blood glucose levels are normal or slightly decreased.
In diabetic ketoacidosis, fruity breath odor commonly acompanies the development of ketoacidosis over 1 to 2 days. Other findings include polydipsia, polyuria, nocturia, weak and rapid pulse, hunger, weight loss, weakness, fatigue, nausea, vomiting, and abdominal pain. Eventually, Kussmaul’s respirations, orthostatic hypotension, dehydration, tachycardia, confusion, and stupor occur. Signs and symptoms may lead to coma.
Starvation ketoacidosis is a potentially life-threatening disorder that has a gradual onset. Besides fruity breath odor, typical findings include signs of cachexia and dehydration, decreased LOC, bradycardia, and a history of anorexia nervosa.
Any drug known to cause metabolic acidosis, such as nitroprusside and salicylates, can result in fruity breath odor.
Diets that promote little or no carbohydrate intake may cause ketoacidosis and the resulting fruity breath odor.
The effects of diabetes mellitus result from insulin deficiency. Insulin transports glucose into the cell for use as energy and storage as glycogen. It also stimulates protein synthesis and free fatty acid storage. Insulin deficiency or resistance compromises the body tissues’access to essential nutrients for fuel and storage.
Type 1A results from autoimmune beta-cell destruction, resulting in insulin deficiency. Type 1B leaves these immunologic markers but results in insulin deficiency and kerosis.
Other risk factors include the following:
❑ Obesity contributes to the resistance to endogenous insulin.
❑ Physiologic or emotional stress can cause prolonged elevation of stress hormone levels (cortisol, epinephrine, glucagon, and growth hormone). This raises blood glucose levels, which, in turn, places increased demands on the pancreas.
❑ Pregnancy causes weight gain and increases levels of estrogen and placental hormones, which antagonize insulin.
❑ Some medications can antagonize the effects of insulin, including thiazide diuretics, adrenal corticosteroids, and hormonal contraceptives.
With DKA, fruity breath odor commonly occurs as ketoacidosis develops over 1 to 2 days. Other findings include polydipsia, polyuria, nocturia, weak and rapid pulse, hunger, weight loss, weakness, fatigue, nausea, vomiting, and abdominal pain. Eventually, Kussmaul’s respirations, orthostatic hypotension, dehydration, tachycardia, confusion, and stupor occur. Signs and symptoms may lead to coma.
Starvation ketoacidosis is a potentially life-threatening disorder that has a gradual onset. Besides fruity breath odor, typical findings include signs of cachexia and dehydration, decreased LOC, bradycardia, and a history of severely limited food intake (anorexia nervosa).
Severe weight loss associated with anorexia nervosa may produce fruity breath, usually with nausea, constipation, and cold intolerance as well as dental enamel erosion and scars or calluses in the dorsum of the hand, both related to induced vomiting.
Fruity breath odor accompanies alcoholic ketoacidosis, which is usually seen in poorly nourished alcoholics with vomiting, abdominal pain, and only minimal food intake over several days. Kussmaul’s respirations begin abruptly and accompany dehydration, abdominal pain and distention, and absent bowel sounds. Blood glucose levels are normal or slightly decreased.
With diabetic ketoacidosis, fruity breath odor commonly occurs as ketoacidosis develops over 1 to 2 days. Other findings include polydipsia, polyuria, nocturia, weak and rapid pulse, hunger, weight loss, weakness, fatigue, nausea, vomiting, and abdominal pain. Eventually, Kussmaul’s respirations, orthostatic hypotension, dehydration, tachycardia, confusion, stupor, and coma may occur.
Starvation ketoacidosis is a potentially life-threatening disorder that has a gradual onset. Besides fruity breath odor, typical findings include signs of cachexia and dehydration, decreased level of consciousness, bradycardia, and a history of severely limited food intake (anorexia nervosa).
Any drug known to cause metabolic acidosis, such as nitroprusside and salicylates, can result in fruity breath odor.
Low-carbohydrate diets, which encourage little or no carbohydrate intake, may cause ketoacidosis and a resulting fruity breath odor.
Anorexia nervosa.Severe weight loss associated with anorexia nervosa may produce fruity breath, usually with nausea, constipation, and cold intolerance as well as dental enamel erosion and scars or calluses in the dorsum of the hand, both related to induced vomiting.
Ketoacidosis.Fruity breath odor accompanies alcoholic ketoacidosis, which is usually seen in poorly nourished alcoholics with vomiting, abdominal pain, and only minimal food intake over several days. Kussmaul's respirations begin abruptly and accompany dehydration, abdominal pain and distention, and absent bowel sounds. Blood glucose levels are normal or slightly decreased.
With diabetic ketoacidosis, fruity breath odor commonly occurs as ketoacidosis develops over 1 or 2 days. Other findings include polydipsia, polyuria, nocturia, a weak and rapid pulse, hunger, weight loss, weakness, fatigue, nausea, vomiting, and abdominal pain. Eventually, Kussmaul's respirations, orthostatic hypotension, dehydration, tachycardia, confusion, and stupor occur. Signs and symptoms may lead to coma.
Starvation ketoacidosis is a potentially life-threatening disorder that has a gradual onset. Besides fruity breath odor, typical findings include signs of cachexia and dehydration, a decreased LOC, bradycardia, and a history of severely limited food intake.
Drugs.Any drug known to cause metabolic acidosis, such as nitroprusside and salicylates, can result in fruity breath odor.
Low-carbohydrate diets.These diets, which encourage little or no carbohydrate intake, may cause ketoacidosis and the resulting fruity breath odor.
Other conditions that might have
Diabetic Ketoacidosis as a complication may,
potentially, be an underlying cause of Diabetic Ketoacidosis.
Our database lists the following as having
Diabetic Ketoacidosis as a complication of that condition:
Conditions listing Diabetic Ketoacidosis
as a symptom may also be potential underlying causes of Diabetic Ketoacidosis.
Our database lists the following as having
Diabetic Ketoacidosis as a symptom of that condition:
Causes: Diabetic Ketoacidosis:
Build-up of ketones in the blood from high blood sugars.
The following medical news items are relevant to causes of Diabetic Ketoacidosis:
As with all medical conditions,
there may be many causal factors.
Further relevant information on causes of Diabetic Ketoacidosis may be found in:
Next articles: Tools & Services:
Medical Articles:
Breath with fruity odor:
Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))
Anorexia nervosa
Ketoacidosis
Other causes
Drugs
Low-carbohydrate diets
Diabetes mellitus:
Causes
(Handbook of Diseases)
Breath odor, fruity:
Medical causes
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Anorexia nervosa
. Severe weight loss associated with anorexia nervosa may produce fruity breath, usually with nausea, constipation, and cold intolerance as well as dental enamel erosion and scars or calluses in the dorsum of the hand, related to induced vomiting.
Ketoacidosis
Fruity breath odor accompanies alcoholic ketoacidosis, which is usually seen in poorly nourished alcoholics with vomiting, abdominal pain, and only minimal food intake over several days. Kussmaul’s respirations begin abruptly and accompany dehydration, abdominal pain and distention, and absent bowel sounds. Blood glucose levels are normal or slightly decreased.
Other causes
Drugs
Any drug known to cause metabolic acidosis, such as nitroprusside and salicylates, can result in fruity breath odor.
Low-carbohydrate diets
Low-carbohydrate diets, which encourage little or no carbohydrate intake, may cause ketoacidosis and the resulting fruity breath odor.
Breath with fruity odor:
Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Anorexia nervosa
Ketoacidosis
Other causes
Drugs
Low-carbohydrate diets
Breath with fruity odor:
Medical causes
(Nursing: Interpreting Signs and Symptoms)
Other causes
Diabetic Ketoacidosis as a complication of other conditions:
Diabetic Ketoacidosis as a symptom:
What causes Diabetic Ketoacidosis?
Medical news summaries relating to Diabetic Ketoacidosis:
Related information on causes of Diabetic Ketoacidosis:
» Next page: Risk Factors for Diabetic Ketoacidosis
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