1. Chemistry Presentation: Diabetic Ketoacidosis
BY: Leor Surilov

2. Table of Contents What is Diabetic Ketoacidosis (DKA)?
Biochemistry of DKA
Complications/symptoms of DKA
Why is this important to discuss?
How is this related to chemistry?
Conclusion

3. WHAT is Diabetic Ketoacidosis (DKA)
Hyperglycemia
Acidosis
Ketosis
Diabetic Ketoacidosis
The Definition of DKA is the presence of the following:
Hyperglycemia: meaning there is a high concentration of sugar in your blood
Ketosis: Is the increase of the production of ketone bodies in the body
3) Acidosis: Is the decrease of the pH of the body (pH < 7.3)

4. Biochemistry of Diabetic Ketoacidosis

5. Complications/Symptoms of DKA
Lethargy (lack of energy) and drowsiness
Vomiting
Dehydration
Deep breathing (hyperventilation)
Infection
Abdominal pain
Hyponatraemia ( low levels of sodium in your body)
Shock

6. Why is this Important
DKA commonly occurs in patients with type 1 diabetes, and is usually the initial presentation for many type I diabetics
Type I diabetes, is an autoimmune disease the leads to the destruction of pancreatic ß cells that are involved with hormone insulin production
Insulin is a hormone that allows glucose to enter the cell throughout the body and is therefore maintains plasma glucose levels
Therefore without insulin the body can not use glucose (carbohydrates) and must use an alternative energy source

7. Diabetes According to the American Diabetes Association:
Prevalence: in 2012, million Americans, or 9.3% of the population, had diabetes
Approximately 1.25 million American children and adults have type 1 diabetes
Prevalence in seniors is 25.9% (diagnosed and undiagnosed)
Diabetes remains the 7th leading cause of death in the US in 2010

8. How is this Related to Chemistry: Introduction
Acid-Base Balance
The pH of the body is maintained within a very narrow in order to function normally
Normal plasma [H+] is low
The presence of buffers throughout the body help maintains proper pH
Two components of the body that generally remove acids are:
Lungs (volatile acids)
Kidneys (non-volatile acids)
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9. How is this Related to Chemistry: Lungs
The primary buffer in the body is bicarbonate, which contributes to the acid-base balance created by carbon dioxide
DKA most often presents with hyperventilation in order to adjust the acidosis
This is Le Chatelier’s Principle, the increase breathing out of carbon dioxide shifts the equilibrium to the right
The shift involves hydrogen ions combining with bicarbonate to produce carbonic acid, which leads to the dissociating into carbon dioxide to compensate
This leads to the decrease in [H+]
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10. How is the Related to Chemistry: Kidneys
The kidney is a filter and contributes to acid-base balance, either through adjusting the electrolyte balance or by removing non-volatile acids such as sulfate and phosphate
The kidney does this by a process called ammoniageneisis, which bicarbonate is produced and ammonium is excreted in urine
This pathway uses Le Chatelier’s Principle by decreasing [H+] shifting the equilibrium to compensate
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11. Conclusion
DKA often occurs in people with type I diabetes, usually as their initial presentation
DKA involves products that decrease the normal pH (acidosis)
The body uses acid-base chemistry to maintain the normal pH using buffers
The lungs and kidneys use Le Chateliers principle in the bicarbonate/carbon dioxide equation to adjust the acid- base balance

12. References
Brown, T. A. (2012). Rapid review physiology. Philadelphia, PA: Mosby/Elsevier.
Longmore, M., Wilkerson, I. B., Baldwin, A., & Wallin, E. (2014). Oxford Handbook of Clinical Medicine (9th ed.). Oxford: Oxford University Press
MCAT General Chemistry Review Notes. (2010). New York, NY: Kaplan.
Statistics About Diabetes. (n.d.). Retrieved June 29, 2016, from basics/statistics/?referrer=