Acidosis is when the pH of the blood becomes lower than normal because of increasing acidity.

Ketoacidosis is when the acidity is due to ketone bodies. These are produced in a diabetic as a complication of Insulin-dependent Diabetes Mellitus due to the breakdown of fatty acids to provide glucose for the brain's consumption (paradoxically, in diabetics there is a lot of glucose in the blood but little available for the brain).

In diabetic ketoacidosis, the major ketone bodies produced are acetoacetic acid and beta-hydroxybutyric acid. The marked hyperglycaemia causes osmotic diuresis, leading to excessive losses of water, sodium and potassium.

Signs of ketoacidosis include lethargy, lowered level of consciousness, an increased respiratory rate (Kussmaul breathing) and the smell of ketones on the patient's breath. Early symptoms are polyuria, nausea, vomiting and abdominal pain, with lethargy and somnolence a later development, progressing to unconsciousness and coma if untreated.

Ketoacidosis is a medical emergency. The patient requires IV fluids and insulin urgently. A bicarbonate infusion may be necessary if the pH of the blood is less than 7.

--> also see acidosis, alkalosis, diabetes mellitus, insulin-dependent diabetes mellitus

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