Diabetic Ketoacidosis (DKA)

What is Diabetic Ketoacidosis?

Diabetic ketoacidosis (DKA) is a serious complication that most often occurs in those with type 1 diabetes. They require supplemental insulin injections because their bodies produce little to no insulin.

When illness occurs, insulin requirements can increase. Diabetic ketoacidosis can strike type 1 diabetics that do not receive their injections and those with an underlying condition. When the body lacks sufficient amounts of insulin, it begins burning fat for energy instead of glucose. When the fat cells break down and glucose remains in the bloodstream, acid levels (ketones) continue to rise.Diabetic ketoacidosis can lead to a coma and can be fatal if not treated.

What are the Symptoms of Diabetic Ketoacidosis?

Blood tests are required to diagnose diabetic ketoacidosis.

Symptoms include:

  • Extreme thirst
  • Increased urination
  • Queasiness
  • Vomiting
  • Lethargy
  • Fruity smelling breath
  • Confusion
  • Stomach pain
  • High blood sugar readings
  • High ketone readings

Diabetic KetoacidosisĀ Causes

The main cause of DKA is low insulin levels. The body uses insulin to transport glucose from the bloodstream to the muscles. If insulin levels are low, the muscles do not receive the glucose, and so the body turns to another source of fuel – fat tissue. Stored body fat is broken down and converted into ketones, which the muscles can use as fuel as well as sugar. If the level of ketones in the blood becomes too high, the symptoms of DKA may develop.

The main trigger for high ketone levels in the blood is missed insulin treatments, or a dosage level that is too low for your particular circumstances. Illnesses that cause the release of catabolic hormones such as adrenaline or cortisone can also increase ketone levels in the blood. Pneumonia and urinary tract infections are particularly common causes of DKA. High stress levels, drug use, alcohol consumption, and interactions with other medications are other known causes of DKA.

How is Diabetic Ketoacidosis Treated?

Treatment for diabetic ketoacidosis can occur in the hospital emergency room or as an inpatient in the ICU.

Treatments include:

  • Oral or IV fluids to dilute blood glucose
  • Intravenous electrolytes
  • Insulin therapy
  • Tests to find an underlying cause of diabetic ketoacidosis such as infection or heart attack

To overcome diabetic ketoacidosis, blood sugar levels must be reduced below 240 mg/dL. It is of the utmost importance for those with diabetes mellitus to monitor their blood glucose levels as instructed by their doctor to avoid diabetic ketoacidosis and other complications.

Diabetic KetoacidosisĀ Prevention

The main preventive step that you can take against DKA is to take your diabetes medications, especially insulin, as directed. If you feel that your prescribed insulin levels are not at an appropriate level for you, you should discuss this with your doctor.

If you are suffering from an illness or injury, or if you are recovering from surgery, you should take extra care because some illnesses can affect blood glucose levels. You may need to make adjustments to your insulin levels or your dietary habits to keep your blood glucose as close to the normal range as possible. You can use blood glucose monitoring tools as well as ketone testing kits to help you do this.

You should also avoid excessive consumption of alcohol, and the use of recreational drugs.

Diabetic Ketoacidosis (DKA)
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Last Reviewed:
September 20, 2016
Last Updated:
December 14, 2017
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