Unless related to omission of insulin therapy, DKA is usually precipitated by coexisting illness. The most common factor is infection ranging from trivial viral infections to full-blown septicaemia. Other precipitating factors are cardiovascular events (myocardial infarction, stroke), gastrointestinal disease, inflammatory diseases, pancreatitis, trauma and major surgery, alcohol abuse and drugs (e.g. glucocorticoids). All of these factors induce insulin resistance due to stress hormone responses. Furthermore, poor appetite and food deprivation will often lead the patient to take less insulin, erroneously of course. In this context gastrointestinal disease with nausea and vomiting poses a specific problem and it may be necessary to admit such patients to hospital for intravenous glucose and insulin therapy.
Psychological factors also play an important role. Poor compliance is commonly seen in younger patients, patients with psychiatric illnesses and in minority groups with poor understanding of diabetes care principles for linguistic or cultural reasons.
Was this article helpful?
Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...