Diabetic Ketoacedosis

Running head: DIABETIC KETOACEDOSIS
Diabetic Ketoacedosis
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1DIABETIC KETOACEDOSIS
Diabetic Ketoacidosisis caused due to a deficiency of insulin in the body. As a result
of the insulin deficiency, the amino acids and triglycerides in the body are metabolized to
release energy by the process of lipolysis (Hoffman et al., 2017). This results in a rise in the
levels of free fatty acids, glycerol and Alanine in the serum. Also excess glucagon caused due
to the deficiency of insulin causes the alanine and glycerol act as substrates for hepatic
gluconeogenesis and glugagon leads to the conversion of free fatty acids into ketones in the
mitochondria (Soto-Rivera et al., 2017). The rise in ketones further causes production of beta-
hydroxybutyric acid and acetoacetic acid that causes metabolic acidosis (Sulimani et al.
2018). The pH of blood decreases due to this, making it acidic (Adachi et al., 2017).
DKA can significantly deteriorate the health condition of the patient and can be fatal
is not treated timely (Møller, 2017). According to Gilbert and Byard (2018), the acidification
of the blood (or metabolic acidosis) can lead to the production of excess hydrogen ions and
insufficient production of bicarbonate ion. This can cause several serious consequences such
as respiratory acidosis, coma and even death.
One of the most effective treatment strategies for DKA is the use of a combination of
dapagliflozin and insulin. Dapagliflozin is a selective inhibitor which is orally active which
can inhibit renal SGLT2 (renal sodium-glucose co-transporter type 2) and therefore used for
the treatment of type 2 diabetes (or diabetes mellitus) (Storgaard et al., 2016).
Ethical and legal principles of person centered care in a critical care environment
include the following aspects: The Code of Ethics, Rights based patient constitutions,
Confidentiality policies, Quality of care policies (Health.gov.au, 2019; Oecd.org, 2019;
Nursingmidwiferyboard.gov.au, 2019).
In situations where the patient’s condition is rapidly deteriorating, the healthcare
professionals in charge of the patient’s care have the role of initiating a rapid response

2DIABETIC KETOACEDOSIS
system for the patient in order to quickly identify the condition and respond to it accordingly
(Safetyandquality.gov.au, 2019). The rapid response system involves the following steps:
Event recognition and triggering response; Crisis Response; Process Improvement; and
Administration:
The response arm of the rapid response system includes the medical emergency team, rapid
response team, critical care outreach, ICU liaison nurses as well as alternate systems of care
delivery (Safetyandquality.gov.au, 2019).
Figure: Rapid response system in an acute care setting. Source (Safetyandquality.gov.au,
2019)