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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? How is this related to chemistry? Conclusion. WHAT is Diabetic Ketoacidosis (DKA).
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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? • How is this related to chemistry? • Conclusion
WHAT is Diabetic Ketoacidosis (DKA) 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)
Biochemistry of Diabetic Ketoacidosis • 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) Retrieved from: http://altered-states.net/barry/update178/DigestiveTract.jpg
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+] Retrieved from: https://fmss12uchemd.files.wordpress.com/2013/05/eqn10.jpg
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/