Diabetic ketoacidosis (DKA) is a serious condition that is linked to diabetes. If you don’t have enough insulin to help your body process sugars (glucose), your body will start burning fat to fuel itself. As a result, acids called ketone bodies build up in the body.
Left untreated, these ketone bodies poison you. DKA can occur in people who have type 1 or type 2 diabetes, but it’s considered more rare in those with type 2. DKA can also appear if you are at risk for diabetes but have not received a formal diagnosis. It can be the first sign of type 1 diabetes.
DKA is a medical emergency. If you suspect this complication, immediately contact your physician or go to an emergency room.
If you have type 1 diabetes and have a glucometer reading of over 300 milligrams per deciliter, you should test your urine for ketones. Call your doctor if moderate or high levels of ketones are present. Always seek medical help if you have unexplained nausea and vomiting.
The most common triggers for the breakdown of fat that causes DKA are:
Your risk of developing DKA might be higher if you:
Although DKA is rare in people who have type 2 diabetes, it does occur.
Symptoms of DKA can appear quickly and may include:
If you have type 1 diabetes, you should maintain a supply of home urine tests. A high ketone test result after one of these tests is a symptom of DKA. This test may show that you have high ketone levels in your urine.
If left untreated, DKA can lead to a coma or death. All people who use insulin should discuss the risk of DKA with their healthcare team, to make sure a plan is in place.
It is important to make sure you consult with your doctor if you experience any of these symptoms:
Testing for ketones in a sample of urine is one of the first steps for diagnosing DKA. Tests of blood acidity and sugar levels are also commonly done. Other tests your doctor may order are:
The treatment for DKA usually involves a combination of several approaches to normalize abnormal blood sugar and insulin levels. If you’re diagnosed with DKA but have not yet been diagnosed with diabetes, your doctor will create a diabetes treatment plan to keep ketoacidosis from reoccurring. If your DKA is a result of an infection or illness, your doctor will treat that as well, likely with antibiotics.
You should replace fluids. At the hospital, your physician will likely give you fluids (orally, if possible, or intravenously) to replace the fluid that is usually lost as a result of DKA. Fluid replacement is also helpful in diluting the amount of sugar in your blood.
Insulin will likely be administered to you intravenously until your blood sugar level falls below 240 mg/dL. When your blood sugar levels are within an acceptable range, your physician may let you resume your normal insulin regimen.
Lower than normal levels of insulin can cause the levels of electrolytes in your body to become abnormally low. Electrolytes are electrically charged minerals that help your body—including the heart and nerves—function properly. Electrolyte replacement is also commonly done intravenously.
There are many ways to prevent DKA. One of the most important is proper management of diabetes. Take your diabetes medication as directed, eat healthfully, and monitor your blood glucose to help prevent DKA.
Additional preventive measures include: