The province of Newfoundland and Labrador has one of the highest rates of type 1 diabetes (T1D) and hospitalizations for diabetic ketoacidosis (DKA) in the world. DKA is an acute and life threatening complication of diabetes, caused by an insulin deficiency. DKA is characterized by the triad of hyperglycemia, metabolic acidosis, and increased total body ketone concentration. Without insulin, the body cannot support the uptake of glucose for energy production, so it burns fat instead. This results in the build up of acidic metabolites which are poisonous in the blood at high levels. DKA is the leading cause of illness and death in youth with T1D.
  
Previous research in NL has shown that of newly diagnosed patients presenting in DKA, 64% had seen a physician in the weeks leading up to diagnosis, indicating the diagnosis of diabetes was missed by primary care physicians. However, the diagnosis of T1D is associated with a predictable pattern of symptoms, and most cases of DKA could be prevented with earlier diagnosis and improved education among patients, their families, and their health care providers.
 
The most common presenting symptoms of DKA include:

• Polyuria (increased urination) and bedwetting
• Polydipsia (increased thirst)
• Weight loss
• Neurologic symptoms (confusion or difficulties concentrating)
• Weakness or fatigue
• Abdominal pain
• Nausea and vomiting

 
These symptoms can manifest into:

• Tachycardia (an abnormally fast heart rate)
• Dizziness and confusion
• Fruity breath
• Drowsiness
• Unconsciousness
• Cerebral edema (swelling in the brain)  

To promote patient and physician education surrounding the prevention of DKA, a brochure, posters, and video resources have been developed to help increase awareness of the signs and symptoms of this illness.  Please find these resources below.

Diabetic Ketoacidosis Poster 1

Diabetic Ketoacidosis Poster 2

DKA Brochure