Diabetic Ketoacidosis
- Normal level of ketone bodies in blood < 1mg/dL
- Ketosis
- When synthesis > utilisation , ketone bodies in blood ↑ – ketonemia
- Excreted in urine – Ketonuria
- Acetone in breath
- Rothera's test
- Rothera's Powder - Sodium Nitroprusside + Ammonium sulphate
- 5 ml urine + 1 gm of Rothera's powder and mix well
- Add 1-2 ml of Liquor Ammonia ( Conc. Ammonium Hydroxide)
- Purple Ring appears at the interface
| Starvation Ketosis | Benedict's Negative | Rothera's Positive |
| Diabetic Ketosis | Benedict's Positive | Rothera's Positive |
- Metabolic acidosis- ↑ anion gap - reduced buffers like bicarbonate
- Kussumaul’s respiration: compensatory hyperventilation
- Osmotic diuresis → dehydration
- Sodium loss: Ketone bodies excreted as sodium salt
- High potassium
- Coma
Textbook of Biochemistry for Medical Students, DM Vasudevan pg.288