A patient’s chart indicates a history of ketoacidosis. Which of the following would you not expect to see with this patient if this condition were acute?
A. Vomiting
B. Extreme Thirst
C. Weight gain
D. Acetone breath smell
Correct Answer: C. Weight gain
Rapid weight loss occurs in patients newly diagnosed with type 1 diabetes. In people with diabetes, insufficient insulin prevents the body from getting glucose from the blood into the body’s cells to use as energy. When this occurs, the body starts burning fat and muscle for energy, causing a reduction in overall body weight.
Option A: Nausea and vomiting usually occur and may be associated with diffuse abdominal pain, decreased appetite, and anorexia. As the blood glucose levels rise and fall, the body’s metabolism can get interrupted and confused which can lead to a mixed feeling of nausea.
Option B: The incidence of increased water loss results in extreme thirst and dehydration. If our blood glucose levels are higher than they should be for prolonged periods of time, our kidneys will attempt to remove some of the excess glucose from the blood and excrete this as urine. Whilst the kidneys filter the blood in this way, water will also be removed from the blood and will need replenishing. This is why we tend to have increased thirst when our blood glucose levels run too high.
Option D: A characteristic sign of ketoacidosis is acetone (ketotic) breath or a fruity smell. When the body can’t get energy from glucose, it burns fat in its place. The fat-burning process creates a buildup of acids in the blood called ketones, which leads to DKA if untreated. Fruity-smelling breath is a sign of high levels of ketones in someone who already has diabetes.