The document discusses diabetic ketoacidosis (DKA), a life-threatening complication of diabetes that occurs when there is not enough insulin in the body. DKA is characterized by hyperglycemia, ketosis, and acidosis. It presents with symptoms like vomiting, dehydration, and deep breathing. The body maintains acid-base balance through buffers like bicarbonate that are regulated by the lungs and kidneys using principles of chemistry. Treatment of DKA focuses on rehydration and insulin administration to restore proper acid-base balance.

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?
 Are there any treatments?
 How is this related to chemistry?
 Conclusion

3. 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 body
3) Acidosis: Is the decrease of the pH of the body (pH < 7.3)

4. BIOCHEMISTRY OF DIABETIC KETOACIDOSIS
 Video: https://www.youtube.com/watch?v=t5h4YDsfS2c

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, 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

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)
Retrieved from: http://altered-
states.net/barry/update178/DigestiveTract.jpg

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+]
Retrieved from: https://fmss12uchemd.files.wordpress.com/2013/05/eqn10.jpg

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

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