Diabetic ketoacidosis (DKA) is a serious condition in which uncontrolled hyperglycemia (usually due to complete lack of insulin or relative insulin deficiency) over time creates a buildup of ketones ( acidic waste products) in the blood. Low insulin levels cause the liver to turn fatty acids into ketones for fuel (ketosis); ketone bodies are intermediate substrates in that metabolic sequence. This is normal if periodic, but can become a serious problem if prolonged. Elevated levels of ketone bodies in the blood decrease blood pH, leading to DKA. High levels of ketones can be very harmful. Diabetic ketoacidosis can be precipitated by infections, stress, trauma, lack of medications such as insulin, or medical emergencies such as stroke and heart attack. the patient with DKA is typically dehydrated and breathes rapidly and deeply. Abdominal pain is common and can be severe. The level of consciousness is typically normal until late in the process, when lethargy may progress to coma. Ketoacidosis can easily become severe enough to cause hypotension, shock, and death. Ketoacidosis is much more common in type 1 diabetes than in type 2. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get Original Essay Hyperosmolar hyperglycemic nonketotic syndrome (HNS) is a serious condition in which the blood sugar level becomes very high. The body tries to eliminate excess sugar in the blood by eliminating it in the urine, water is drawn osmotically from the cells into the blood, and the kidneys eventually begin to discharge the glucose into the urine. This results in water loss and increased blood osmolarity. If fluids are not replenished (orally or intravenously), the osmotic effect of high glucose levels, combined with water loss, will eventually lead to dehydration. The cells of the body progressively dehydrate as water is taken from them and excreted. Electrolyte imbalances are also common and are always dangerous. This significantly increases the amount of urine and often leads to dehydration so severe that it causes seizures, coma, and even death. This syndrome typically occurs in patients with type 2 diabetes who do not control their blood sugar levels, who are dehydrated, or who are suffering from stress, injury, stroke, or who are taking certain medications, such as steroids. Lethargy may eventually progress to coma, although this is more common in type 2 diabetes than in type 1 diabetes. Patients with poorly controlled diabetes mellitus are prone to bacterial and fungal infections due to the adverse effects of hyperglycemia on function of granulocytes and T cells. The most common are mucocutaneous fungal infections (e.g. oral and vaginal candidiasis) and bacterial foot infections (including osteomyelitis), which are typically exacerbated by vascular insufficiency of the lower extremities and diabetic neuropathy. Hypoglycemia, or abnormally low blood glucose, is an acute complication of several diabetes treatments. It is otherwise rare, both in diabetic and non-diabetic patients. The patient may become agitated, sweaty, weak, and exhibit many symptoms of sympathetic activation of the autonomic nervous system resulting in feelings similar to terror and immobilized panic. Consciousness can be impaired or even lost in extreme cases, leading to coma, seizures or even brain damage and death. In patients with diabetes, this can be caused by several factors, such as excessive or incorrectly timed insulin, excessive or incorrectly timed exercise (exercise decreases the., 2011).