What is the Difference Between Diabetic Ketoacidosis and Starvation Ketoacidosis

The key difference between diabetic ketoacidosis and starvation ketoacidosis is that diabetic ketoacidosis is due to a lack of insulin directing blood sugar into the cells, while starvation ketoacidosis is due to prolonged fasting.

Ketoacidosis is a metabolic condition associated with high levels of ketones in the blood. Ketones normally build up in the blood when the body breaks down fatty acids to use for energy in place of carbohydrates. Clinically relevant forms of ketoacidosis include diabetic ketoacidosis, alcoholic ketoacidosis, and starvation ketoacidosis.

CONTENTS

1. Overview and Key Difference
2. What is Diabetic Ketoacidosis 
3. What is Starvation Ketoacidosis
4. Similarities – Diabetic Ketoacidosis and Starvation Ketoacidosis
5. Diabetic Ketoacidosis vs Starvation Ketoacidosis in Tabular Form
6. Summary – Diabetic Ketoacidosis vs Starvation Ketoacidosis

What is Diabetic Ketoacidosis?

Diabetic ketoacidosis is a type of ketoacidosis that is due to a lack of insulin that directs blood sugar into the cells. This medical condition occurs when the body can’t produce enough insulin. The insulin hormone normally helps sugar molecules like glucose to enter body cells. Glucose is the major source of energy for muscles and other tissues. Without insulin, the body begins to break fat as fuel. This process produces a build-up of acids in the blood called ketones. This will eventually lead to diabetic ketoacidosis if untreated. The triggers of diabetic ketoacidosis include illness, problems with insulin therapy, physical or emotional trauma, heart attack, pancreatitis, pregnancy, alcohol or drug abuse, and certain medications like corticosteroids. The symptoms of diabetic ketoacidosis include excessive thirst, frequent urination, nausea, vomiting, stomach pain, weakness, shortness of breath, fruity-scented breath, and confusion. The more specific signs of diabetic ketoacidosis include high blood sugar levels and high ketone levels in urine.

This condition can be diagnosed through blood tests, urine analysis, chest X-rays, and electrocardiograms. Furthermore, diabetic ketoacidosis can be treated by fluid replacement, electrolyte replacement, and insulin therapy.

What is Starvation Ketoacidosis?

Starvation ketoacidosis is a type of ketoacidosis that is due to prolonged fasting. Starvation ketoacidosis occurs when the body has not received enough glucose as its primary energy for a long time period. There are various reasons why a person may have fasted for a prolonged period: economic factors, dieting, eating disorders, difficulty in swallowing, and cancer. During starvation, fatty acids replace glucose as the primary source of fuel for the body. Fatty acids breakdown leads to the generation of ketones in the blood. The symptoms of starvation ketoacidosis may include lower muscle mass, lower body temperature, minimal body fat, low pulse rate, obvious bony prominences, sparse, thin, dry hair, low blood pressure, dehydration, altered mental state, fatigue, tachypnea, and Kussmaul breathing.

This condition can be diagnosed through physical examination, blood tests, and urine analysis. Furthermore, treatment options for starvation ketoacidosis may include giving dextrose, volume resuscitation with normal saline or lactated ringers, correcting any concomitant electrolyte abnormalities, and considering the risk of refeeding syndrome.

What are the Similarities Between Diabetic Ketoacidosis and Starvation Ketoacidosis?

• Diabetic ketoacidosis and starvation ketoacidosis are two forms of ketoacidosis.
• In both forms, fatty acids replace glucose as the primary source of fuel for the body.
• In both forms, the ketone level in the blood increases.
• They have similar diagnosis tests.
• Both forms are treatable by reversing underlying conditions.

What is the Difference Between Diabetic Ketoacidosis and Starvation Ketoacidosis?

Diabetic ketoacidosis is a type of ketoacidosis due to a lack of insulin that directs blood sugars into the cells, while starvation ketoacidosis is a type of ketoacidosis due to prolonged fasting. Thus, this is the key difference between diabetic ketoacidosis and starvation ketoacidosis. Furthermore, triggers of diabetic ketoacidosis include illness, problems with insulin therapy, physical or emotional trauma, heart attack, pancreatitis, pregnancy, alcohol or drug abuse, and certain medications like corticosteroids. On the other hand, the triggers of starvation ketoacidosis include economic factors, eating disorders, difficulty swallowing, and cancer.

The below infographic presents the differences between diabetic ketoacidosis and starvation ketoacidosis in tabular form for side by side comparison.

Summary – Diabetic Ketoacidosis vs Starvation Ketoacidosis

Diabetic ketoacidosis and starvation ketoacidosis are two forms of ketoacidosis. Diabetic ketoacidosis is a type of ketoacidosis which is due to a lack of insulin, while starvation ketoacidosis is a type of ketoacidosis which is due to prolonged fasting. So, this summarizes the difference between diabetic ketoacidosis and starvation ketoacidosis.

Reference:

1. “Diabetic Ketoacidosis.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention.
2. “Starvation Ketoacidosis: Signs, Causes, Treatment, and More.” Medical News Today, MediLexicon International.

Image Courtesy:

1. “Diabetic Ketoacidosis” By Gblanchard16 – Own work (CC BY-SA 4.0) via Commons Wikimedia
2. “Cat mudpiles – causes of high anion-gap metabolic acidosis” By Savvas Radevic – Own work (CC0) via Commons Wikimedia

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