CHEMISTRY PRESENTATION:DIABETIC KETOACIDOSIS BY: LEOR SURILOV

TABLE OF CONTENTS

What is Diabetic Ketoacidosis (DKA)? Biochemistry of DKA Complications/symptoms of DKA Why is this important to discuss? Are there any treatments? How is this related to chemistry? Conclusion

WHAT IS DIABETIC KETOACIDOSIS (DKA)

Hyperglycemia

AcidosisKetosis

Diabetic Ketoacidosis

• The Definition of DKA is the presence of the following:1) Hyperglycemia: meaning there is a high concentration of sugar in your blood 2) Ketosis: Is the increase of the production of ketone bodies in the body3) Acidosis: Is the decrease of the pH of the body (pH < 7.3)

BIOCHEMISTRY OF DIABETIC KETOACIDOSIS

Video: https://www.youtube.com/watch?v=t5h4YDsfS2c

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

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

DIABETES

According to the American Diabetes Association: Prevalence: in 2012, 29.1 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

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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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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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

Retrieved from: http://www.eclinpath.com/wp-content/uploads/renal-ammonia1.jpg

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

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

http://www.diabetes.org/diabetes-basics/statistics/?referrer=https://www.google.ca/