KETONE BODIES IN BLOOD AND URINE - KETOACIDOSIS

It is a serious condition occasioned by lack of insulin which emanates from use of its own fat by the body to form acids and ketones. Ketones are the outcome of acid substances which are formed when body fat is used to provide energy to the body. The said situation arises due to prolonged fasting, starvation and hunger. Sometimes ketones are seen to develop in pregnant women and children due to strict dieting measures in order to get slim or lose weight.

If glucose and ketones appear in urine tests, it is a clear indication of poor diabetic control, even if their presence may be short-lived or transitory. Too much adherence to street dietary regimen, each or total absence of insulin, weight-reducing measures, calorie-based low carbohydrate diet are said to be causes of ketones. So, diabetic patients must not stretch their dietary regimen and calorie-based process to such an extent that starvation-like situation does occur, so that the body does not start utilizing its own (body) fat to meet energy demands of the system. Though simultaneous presence of ketones and glucose in urine is a rarity (because ketones surface when there is starvation stage and glucose, is present due to lack of insulin and excessive intake of carbohydrates.

Ketoacidosis is an abnormal situation when there is depletion of sodium and potassium in the blood. Concentration of potassium in the plasma depends on glycogen and protein and hormone concentration on one hand, and urinary excretion on the other. Within 2-3 hours of use of use of insulin, fall in plasma potassium may be precipitated. Three conditions are said to be responsible for ketoacidosis:

i. Administration of potassium-free fluid causes dilution of extra-cellular potassium.
ii. As a result of insulin therapy, movement of potassium is caused into the cells, and finally
iii. Continuous renal loss of potassium.
Earlier may diabetic patients used to die from this disease but, now, the discovery and use of insulin has almost prevented deaths due to this complication. Mainly it is the potassium loss which is responsible in causing such a serious upset. Now, hardly a fraction (say merely 2%) of diabetic patients die due to this disorder. Since negligence. The patients should always be aware of the onset development of this complication.